Endohepatology: Arrival at the frontier of interventional endosonography

Abstract

Endohepatology describes the emerging field where diagnostic and therapeutic endoscopic ultrasound (EUS) are used for the diagnosis and management of liver disease and its sequelae. In this editorial we comment on the article by Gadour et al. The spectrum of EUS-guided procedures includes liver parenchymal and lesional biopsy, abscess drainage, treatment of focal liver lesions, diagnosis of portal hypertension and management of gastric varices. The data suggest that the application of EUS to hepatology is technically feasible and safe, heralding the arrival at a new frontier for EUS. More data, specifically randomised trials comparing EUS to interventional radiology techniques, and continued partnership between endoscopy and hepatology are required to see this field establish itself outside expert tertiary centres.

Keywords: Cancer; Cirrhosis; Endoscopy; Endoscopic ultrasound; Liver disease

Core Tip: Endohepatology, where endoscopic ultrasound (EUS) and hepatology are combined, allows for novel and minimally invasive ways to investigate and treat liver disease. These procedures, especially EUS-guided liver biopsy, portal pressure gradient measurement and obliteration of gastric varices, have now been demonstrated to be technically feasible and safe; thus, highlighting the continued expansion, and clinical implications of diagnostic and therapeutic EUS.