Castleberry DT, Mann R, Tharian B, Thandassery RB. Endoscopic ultrasound in the management of complications related to cirrhosis- recent evidence. World J Gastrointest Endosc 2025; 17(9): 108549 [DOI: 10.4253/wjge.v17.i9.108549]
Corresponding Author of This Article
Ragesh Babu Thandassery, MD, Associate Professor, DM, Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, 4300 W 7th Street, Little Rock, AR 72205, United States. doc.ragesh@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Sep 16, 2025; 17(9): 108549 Published online Sep 16, 2025. doi: 10.4253/wjge.v17.i9.108549
Endoscopic ultrasound in the management of complications related to cirrhosis- recent evidence
Drew T Castleberry, Rupinder Mann, Benjamin Tharian, Ragesh Babu Thandassery
Drew T Castleberry, Rupinder Mann, Ragesh Babu Thandassery, Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, AR 72202, United States
Drew T Castleberry, Rupinder Mann, Ragesh Babu Thandassery, Department of Internal Medicine, Division of Gastroenterology, Central Arkansas Veterans Healthcare System, Little Rock, AR 72202, United States
Benjamin Tharian, Department of Gastroenterology, Orlando Health Digestive Health Institute, Bayfront Health, St. Petersberg, FL 33701, United States
Author contributions: Castleberry DT and Mann R were responsible for manuscript writing; Tharian B was responsible for manuscript editing and endoscopic images; Thandassery RB was responsible for concept of manuscript, manuscript editing and final approval of the manuscript; all authors read and approved of the final manuscript.
Conflict-of-interest statement: The authors have no relevant conflicts of interest to disclose. No funds were received. No Artificial intelligence program was used in the writing of this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ragesh Babu Thandassery, MD, Associate Professor, DM, Department of Internal Medicine, Division of Gastroenterology, University of Arkansas for Medical Sciences, 4300 W 7th Street, Little Rock, AR 72205, United States. doc.ragesh@gmail.com
Received: April 17, 2025 Revised: May 25, 2025 Accepted: August 8, 2025 Published online: September 16, 2025 Processing time: 148 Days and 15.8 Hours
Abstract
Advanced endoscopic methods like endoscopic ultrasound (EUS) have recently been applied for the management of complications related to cirrhosis. This includes novel techniques to measure portal pressure gradients, esophageal, gastric, and ectopic varices management, and EUS-assisted treatment of liver tumors. Management of liver tumors has seen significant changes in recent years, and many minimally invasive procedures have been approved, especially in the management of liver cell carcinoma. These are specialized procedures and are performed only in patients with cirrhosis in specialized centers. There are concerns for complications in patients with cirrhosis due to their increased risk of bleeding and the altered hemostatic milieu. This minireview summarizes the recent evidence on using EUS in the management of cirrhosis-related complications.
Core Tip: This minireview discusses various applications of endoscopic ultrasound (EUS)-guided interventions in managing cirrhosis and its complications. We describe updates on the EUS-guided diagnosis and treatment of conditions such as portal hypertension, esophageal and gastric varices, liver biopsy, antitumoral interventions, caudate lobe ablation and sampling, and other indications of EUS-guided procedures, and compare them to the current standards of care. Additionally, we discuss the potential future uses of EUS-guided management, which is currently in its infancy, including antitumoral interventions and the application of artificial intelligence.
