Abstract
As the burden of liver disease in the general populace steadily increases, so does the need for both advanced diagnostic and treatment options. Endoscopic ultrasound is a reliable diagnostic and therapeutic method that has an established role, foremost in pancreatobiliary pathology. This paper aims to summarize the growing role of endoscopic ultrasound in hepatology based on the search of the current literature. A number of applications of endoscopic ultrasound are reviewed, including both noninvasive methods and tissue acquisition in focal and diffuse liver disease, portal hypertension measurement, detection and management of gastric and esophageal varices, treatment of focal liver lesions and staging of pancreatobiliary malignancies, treatment of cystic and solid liver lesions, as well as liver abscess drainage. Both hepatologists and endoscopists should be aware of the evolving role of endoscopic ultrasound in liver disease. The inherent invasive nature of endoscopic examination limits its use to a targeted population identified using noninvasive methods. Endoscopic ultrasound is one the most versatile methods in gastroenterology, allowing immediate access with detection, sampling, and treatment of digestive tract pathology. Further expansion of its use in hepatology is immanent.
Highlights
At the beginning of the 21st century, chronic liver disease (CLD) is a significant public health concern
Noninvasive diagnostic modalities developed in recent years have greatly advanced the evaluation of CLD, but there are still many clinical situations where accurate diagnosis and staging depend on histopathology
We summarized the current data on Endoscopic ultrasound (EUS) applications in liver disease
Summary
At the beginning of the 21st century, chronic liver disease (CLD) is a significant public health concern. The results of this study are interesting and promising and the authors showed that EUS RTE may be a good method for the noninvasive assessment of liver fibrosis in obese patients, it has some limitations, such as LB was not performed in all patients and the sample size. Due to the proximity of the ultrasound device to the liver, EUS allows for a detailed view of a patient’s anatomy in real-time and the avoidance of other structures, including the adjacent vasculature and major bile ducts, reducing procedure-related complications [25] In this way, multiple cores from both right and left liver lobes can be obtained, increasing the adequacy and yield of tissue [26]. A[59r]e.cAenrtecsetundt ystufrdoymfrZohmanZghaent gale.tcaoln. cfiornmfierdmaedhiaghhigdhegdreegeroeef ocof ncsoinstseisntceyncbyetbweetewneEenUSE-UPSP-GPPuGsinugsiang22a-g2a2u-ggeauFgNeAFNneAednleeeadnlde HanVdPHGVinPpGatinienptastwienitths waciuthteaacnudtesuabnadcustuebPaHcu.tTehPeHau. tThhoersasuhtohworesdsahostwroendgaassstorocinagtioanssboectiwateioenn tbheetwtweoenvathrieabtwleso, wvaitrhiaablPeesa, rwsoitnhcaoPrreealarstioonnccoorerfefilcaiteionnt ocfo0e.f9f2ic3ie[6n0t]o. fA0l.t9h2o3u[g6h0]t.hAe lctuhroruenght ltitheeractuurrreesnutgligteesrtasttuhraet sEuUgSg-ePsPtsGthmateaEsUuSr-ePmPeGntmaesaasumreemanesntoaf sdairmecetapnosrotafldpirreecstsuproerteavl aplrueastsiuorneiesvsaalfueaatinodn ifseassaifbelaen, dlafregaesribcllein, ilcaargl etrricallisnaicnadl tcroiamlspaanrdatciovme sptaurdaiteivseasstsuedssieinsgasssteasnsdinagrdstmanedtharoddmoloetghyoanddoloclginyiacanldecffleincitcivalenefefsesctoivf ethniesssmoefththoids amreetnheoeddaerde. nTeheedefadc.tTthheatfathctisthcaatnthbeisacapnarbteoaf a multiprocedural intervention (general endoscopic assessment, variceal screening, and EUS-LB and EUS elastography) that can be done during a single endoscopic exam will presumably affect the acceptance of this method in the future [61]
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