Abstract
Chronic liver disease (CLD) is still a major problem, where the disease progression will lead to liver cirrhosis (LC) or hepatocellular carcinoma (HCC). Portal hypertension (PH) management and loco-regional therapy for HCC have become the cornerstones in advanced liver disease management. Recently, there are studies looking at the potential role of interventional endoscopic ultrasound (EUS) in liver diseases. EUS may be useful in vascular changes of the digestive wall evaluation, performing dynamic assessment of hemodynamic changes, predicting variceal bleeding and rebleeding risk, and assessing the pharmacological effects. In PH management, EUS-guided vascular therapy—which revolves around glue injection, endovascular coil placement/embolization, and combination of both—has shown promising results. As a diagnostic modality for liver cancer, the implementation of EUS in liver diseases is currently not only limited to liver biopsy (EUS-LB) but also in shear-wave elastography (SWE) and portal pressure gradient measurement, as well as portal vein sampling. The application of EUS-guided radiofrequency ablation (EUS-RFA) and tumor injection can also overcome the limitations shown by both modalities without EUS. Nevertheless, establishing EUS as a firm diagnostic and therapeutic modality is still challenging since the performance of interventional EUS requires high expertise and adequate facilities.
Highlights
Since the introduction of endoscopic ultrasound (EUS) in the 1980s, innovation in diagnostic as well as therapeutic EUSguided has emerged, especially for pancreatobiliary disorders [1, 2]
Chronic liver disease (CLD) is a worldwide major problem, which leads to complications, such as liver cirrhosis (LC) or hepatocellular carcinoma (HCC). e diagnosis and management of portal hypertension (PH) have become the cornerstones in daily practice
In the EUSguided approach group, there were no significant complications. Another retrospective study on liver biopsy methods comparison between percutaneous approach and EUSguided approach by Ali et al [6] showed that the median number of portal tracts was found higher in percutaneous group compared to EUS-guided group, but in EUS-guided group have significant in shorter hospital stay (p ≤ 0.004), and less pain complication when compared to percutaneous group (p ≤ 0.0009) [8]
Summary
Since the introduction of endoscopic ultrasound (EUS) in the 1980s, innovation in diagnostic as well as therapeutic EUSguided has emerged, especially for pancreatobiliary disorders [1, 2]. Chronic liver disease (CLD) is a worldwide major problem, which leads to complications, such as liver cirrhosis (LC) or hepatocellular carcinoma (HCC). There have been studies looking about the role of interventional EUS in liver disease. Several factors, such as cost issue, availability, and high expertise to perform this procedure are still become debatable conditions [1, 3]. Is review will discuss about the potential role of EUS from various clinical evidence in liver disorders—including PH and HCC—as two major causes of morbidity and mortality Several factors, such as cost issue, availability, and high expertise to perform this procedure are still become debatable conditions [1, 3]. is review will discuss about the potential role of EUS from various clinical evidence in liver disorders—including PH and HCC—as two major causes of morbidity and mortality
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