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World J Gastroenterol. Feb 7, 2012; 18(5): 401-411
Published online Feb 7, 2012. doi: 10.3748/wjg.v18.i5.401
Update of endoscopy in liver disease: More than just treating varices
Christoforos Krystallis, Gail S Masterton, Peter C Hayes, John N Plevris
Christoforos Krystallis, Gail S Masterton, Peter C Hayes, John N Plevris, Centre for Liver and Digestive Disorders, The Royal Infirmary, University of Edinburgh, Edinburgh EH16 4SA, United Kingdom
Author contributions: Krystallis C performed the literature review; Krystallis C, Masterton GS, Hayes PC and Plevris JN wrote the paper.
Correspondence to: John N Plevris, MD, PhD, FRCPE, FEBGH, Centre for Liver and Digestive Disorders, The Royal Infirmary, University of Edinburgh, 51, Little France Crescent, Edinburgh EH16 4SA, United Kingdom. j.plevris@ed.ac.uk
Telephone: +44-131-242163 Fax: +44-131-2421638
Received: April 11, 2011
Revised: June 2, 2011
Accepted: June 9, 2011
Published online: February 7, 2012
Abstract

The management of complications in liver disease is often complex and challenging. Endoscopy has undergone a period of rapid expansion with numerous novel and specialized endoscopic modalities that are of increasing value in the investigation and management of the patient with liver disease. In this review, relevant literature search and expert opinions have been used to provide a brief overview and update of the current endoscopic management of patients with liver disease and portal hypertension. The main areas covered are safety of endoscopy in patients with liver disease, the use of standard endoscopy for the treatment of varices and the role of new endoscopic modalities such as endoscopic ultrasound, esophageal capsule, argon plasma coagulation, spyglass and endomicroscopy in the investigation and treatment of liver-related gastrointestinal and biliary pathology. It is clear that the role of the endoscopy in liver disease is well beyond that of just treating varices. As the technology in endoscopy expands, so does the role of the endoscopist in liver disease.

Keywords: Cirrhosis; Portal hypertension; Varices; Endoscopic ultrasound; Esophageal capsule; Endoscopic retrograde cholangiopancreatography; Endomicroscopy; Spyglass