Endo-hepatology: Why should we do endoscopic ultrasound-guided interventions to the liver that we could do through the skin?

Abstract

Endoscopic ultrasound (EUS)-guided interventions on the liver such as diffuse biopsy and portal pressure gradient measurement are emerging as potential alternatives to percutaneous procedures. The purpose of this editorial was to address all the indications that could potentially make an EUS-guided approach a possible alternative to the percutaneous procedures with respect to the proce-dures that could join the EUS examination such as upper endoscopy for gastro-esophageal varices, pancreaticobiliary investigation with EUS, and other potential advantages in terms of patient safety. The issue of a holistic gastroenterologist approach was also discussed along with the potential for developing clinical research.

Keywords: Endo-hepatology; Endoscopic ultrasound; Endosonography; Liver disease; Liver biopsy; Portal hypertension

Core Tip: Endo-hepatology is a new branch of gastroenterology that integrates skills of advanced endoscopy with hepatology. New endoscopic and endoscopic ultrasound (EUS) techniques have emerged that are tailored for the management of hepatological patients, such as EUS-guided liver biopsy, EUS-guided measurement of the porto-systemic gradient. The potential advantage of performing such procedures from the inside of the stomach and duodenum instead of the outside of the patient, i.e. percutaneously, were discussed.