ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (On-demand) | May 2023-Session 6 Presentation 2 - Endoscopic Assessment and Management of Portal Hypertension

Video Transcription

Video Summary

The video discusses the assessment and management of liver disease and portal pressures, particularly from an endoscopist's perspective. The speaker emphasizes that they are not a hepatologist, but they provide insights on various diagnostic and therapeutic approaches. They mention that liver stiffness can be measured using endoscopic ultrasound (EUS) instead of fibroscans, and EUS can also be used for screening and treating varices. The speaker highlights the importance of good expertise and collaboration with interventional radiology in managing varices. They discuss the use of cyanoacrylate and glue injections via EUS to treat varices, with successful results shown in studies. The topic then shifts to portal pressure gradient measurement, comparing the EUS approach with hepatic venous pressure gradient measurement by interventional radiology. The speaker presents studies that suggest the accuracy and usefulness of EUS in measuring portal pressure and its correlation with non-invasive scores and liver biopsy findings. They also mention weight loss as a way to improve portal pressure gradients and discuss the benefits of a multidisciplinary clinic approach. The video concludes by highlighting the potential applications of portal pressure gradient measurement, such as assessing response to treatment and post-hepatectomy liver failure risk. Overall, the speaker emphasizes the value of incorporating portal pressure gradient measurement into the assessment and management of liver disease. No specific credits are mentioned in the video transcript.

Asset Subtitle

Reem Z. Sharaiha, MD

Keywords

liver disease

portal pressures

endoscopic ultrasound

varices

portal pressure gradient measurement