Endoscopic ultrasound in chronic liver disease

doi:10.4254/wjh.v12.i6.262

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World Journal of Hepatology

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1948-5182

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World J Hepatol. Jun 27, 2020; 12(6): 262-276
Published online Jun 27, 2020. doi: 10.4254/wjh.v12.i6.262

Endoscopic ultrasound in chronic liver disease

Brian M Fung, Alexander P Abadir, Armen Eskandari, Michael J Levy, James H Tabibian

Brian M Fung, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States

Alexander P Abadir, Department of Medicine, University of California Irvine Medical Center, Orange, CA 92868, United States

Armen Eskandari, Division of Gastroenterology and Hepatology, University of California Davis Medical Center, Sacramento, CA 95817, United States

Michael J Levy, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States

James H Tabibian, Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States

Author contributions: Fung BM and Eskandari A reviewed the literature for relevant original studies and other content and drafted the manuscript; Abadir AP and Levy MJ reviewed the manuscript and provided figures; Tabibian JH provided supervision; all authors provided critical input and approved of the manuscript.

Conflict-of-interest statement: The authors have no financial disclosures or conflicts of interest.

Corresponding author: James H Tabibian, MD, PhD, FACP, Associate Professor, Director of Endoscopy, Department of Medicine, Olive View-UCLA Medical Center, 14445 Olive View Dr., 2B-182, Sylmar, CA 91342, United States. jtabibian@dhs.lacounty.gov

Received: February 29, 2020
Peer-review started: February 29, 2020
First decision: April 7, 2020
Revised: May 9, 2020
Accepted: May 28, 2020
Article in press: May 28, 2020
Published online: June 27, 2020
Processing time: 119 Days and 23.9 Hours

Abstract

Endoscopic ultrasound (EUS) is a minimally invasive diagnostic and therapeutic modality with a number of established as well as evolving uses in patients with chronic liver disease. Compared to other diagnostic tools such as cross-sectional imaging or conventional endoscopy, EUS has been shown to increase diagnostic sensitivity and therapeutic success for many clinical scenarios and applications with a low rate of adverse events. In this review, we discuss and focus on the current and growing role of EUS in the evaluation and/or treatment of hepatobiliary masses, hepatic parenchymal disease, portal hypertension, esophageal and other varices, and indeterminate biliary strictures.

Keywords: Endoscopy; Cirrhosis; Liver mass; Liver biopsy; Variceal bleeding

Core tip: Endoscopic ultrasound (EUS) is a minimally invasive diagnostic and therapeutic modality with numerous existing and emerging applications in patients with chronic liver disease. In this review, we discuss the role of EUS in the evaluation of hepatobiliary masses, hepatic parenchymal disease, portal hypertension, and indeterminate biliary strictures. We also review how EUS can serve as an ancillary tool to conventional endoscopic and other therapies, including the use of EUS for the treatment of variceal bleeding.