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Review
. 2023 May;43(2):176-188.
doi: 10.1055/s-0043-1769009. Epub 2023 May 16.

Endoscopic Advances in Hepatology

Emma Vanderschueren  1   2 , Jonel Trebicka  3   4 , Wim Laleman  1   2   3
Affiliations
Review

Endoscopic Advances in Hepatology

Emma Vanderschueren et al. Semin Liver Dis. 2023 May.

Abstract

Endoscopy is and remains an indispensable tool in diagnosing and managing liver disease and its complications. Due to the progress in advanced endoscopy, endoscopy has become an alternative route for many surgical, percutaneous, and angiographic interventions, not only as a backup tool when conventional interventions fail but increasingly as a first-line choice. The term endo-hepatology refers to the integration of advanced endoscopy in the practice of hepatology. Endoscopy is key in the diagnosis and management of esophageal and gastric varices, portal hypertensive gastropathy, and gastric antral vascular ectasia. Endoscopic ultrasound (EUS) can be used for the evaluation of the liver parenchyma, liver lesions, and surrounding tissues and vessels, including targeted biopsy and complemented with new software functions. Moreover, EUS can guide portal pressure gradient measurement, and assess and help manage complications of portal hypertension. It is crucial that each present-day hepatologist is aware of the (rapidly increasing) full spectrum of diagnostic and therapeutic tools that exist within this field. In this comprehensive review, we would like to discuss the current endo-hepatology spectrum, as well as future directions for endoscopy in hepatology.

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Conflict of interest statement

J.T. was supported by the German Research Foundation (DFG) project ID 403224013–SFB 1382 (A09), by the German Federal Ministry of Education and Research (BMBF) for the DEEP-HCC project, and by the Hessian Ministry of Higher Education, Research and the Arts (HMWK) for the ENABLE and ACLF-I cluster projects. The MICROB-PREDICT (project ID 825694), DECISION (project ID 847949), GALAXY (project ID 668031), and IHMCSA (project ID 964590) projects have received funding from the European Union's Horizon 2020 research and innovation program.W.L. was also supported by MICROB-PREDICT. W.L. co-chairs the Boston Scientific chair of Therapeutic EUS in HPB disorders and has consultancy agreements with Boston Scientific and Cook.The manuscript reflects only the authors' views, and the European Commission is not responsible for any use that may be made of the information it contains. The funders had no influence on study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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