ASGE Postgraduate Course at ACG 2022: Expanding the Scope of Fundamental and Advanced Endoscopy | October 2022-12 Diehl ASGE Course at ACG-Endohepatology

12 Diehl ASGE Course at ACG-Endohepatology

Pdf Summary

This state-of-the-art lecture by Dr. David L. Diehl focuses on the emerging field of Endohepatology, which refers to the use of endoscopic techniques for the diagnosis and treatment of liver diseases. The lecture covers various topics related to Endohepatology, including common applications such as esophageal variceal diagnosis and management, evaluation of the gallbladder and biliary tree, and EUS-guided liver biopsy. It also discusses emerging applications like EUS shear wave elastography, EUS-assisted gastric variceal treatment, and EUS-guided gallbladder drainage, with the goal of offering a comprehensive evaluation of liver disease in a single procedure.<br /><br />The lecture highlights the advantages of EUS-guided liver biopsy, comparing it to percutaneous or transjugular liver biopsy and noting its outstanding sample yields, excellent safety profile, and the ability to perform other endoscopic procedures in the same session, saving time and costs. The technique for EUS-guided liver biopsy is outlined, with recommendations for optimal sample collection.<br /><br />Another emerging technique discussed is EUS-guided portal pressure measurement as an alternative to the transjugular approach, offering a more acceptable option for patients. The benefits of EUS-portal pressure gradient assessment include unifying patient care within the GI department, performing multiple procedures simultaneously, and earlier diagnosis and intervention for portal hypertension.<br /><br />The lecture also touches on EUS-guided glue injection and coiling for the management of gastric varices, highlighting the use of coils with glue to decrease the incidence of glue embolization. EUS-guided gallbladder drainage is another topic covered, including its indications and technical and clinical success rates.<br /><br />In conclusion, the lecture emphasizes the bright future of Endohepatology and its potential to revolutionize the diagnosis and treatment of liver diseases. EUS-guided techniques are gaining momentum and have shown promise in various applications, allowing for a comprehensive and efficient approach to liver disease evaluation and management.

Keywords

Endohepatology

endoscopic techniques

liver diseases

EUS-guided liver biopsy

EUS shear wave elastography

EUS-assisted gastric variceal treatment

EUS-guided gallbladder drainage

portal pressure measurement

portal hypertension

comprehensive approach