Role of endoscopy in the diagnosis and treatment of gastric mucosal lesions in liver cirrhosis patients.

Abstract

Liver cirrhosis (LC) can cause a wide spectrum of gastric mucosal lesions, the main diagnostic method of which is esophagogastroduodenoscopy. In addition to gastric varices, portal hypertensive gastropathy, gastric antral vascular ectasia, portal hypertensive polyps, peptic ulcer disease can be detected. All of these leave LC patients susceptible to bleeding. If visual differential diagnosis is difficult, endoscopic ultrasound and new digital and optical endoscopic technologies such as magnifying endoscopy with narrow-band imaging may be useful. In many cases, endoscopic technologies are also the methods of choice for the treatment of gastric mucosal lesions in LC patients. In particular, argon plasma coagulation can be used for local treatment of portal hypertensive gastropathy bleeding, and argon plasma coagulation, radiofrequency ablation or endoscopic band ligation is recommended as the main method for local treatment of gastric antral vascular ectasia bleeding. Endoscopic therapy for peptic ulcer bleeding is carried out according to the current guidelines. Besides, endoscopic mucosal resection and endoscopic submucosal dissection may be used in LC patients for the treatment of early gastric cancer. The purpose of this review is to provide up-to-date information on the role of endoscopy in the diagnosis and treatment of gastric mucosal lesions in LC patients.