ASGE Therapeutic EUS for Advanced Endosonographers (On-Demand) | September 2022-EUS Guided Vascular Therapy

Video Transcription

Video Summary

The video transcript is a presentation on various advancements in endohepatology, particularly focusing on liver biopsy, portal pressure measurement, and endoscopic treatment of gastric varices. The speaker explains that endoscopic ultrasound (EUS) has become the main player in therapeutic endoscopy and is the cornerstone of endohepatology. EUS allows for a one-stop-shop approach to liver disease evaluation, where referrals for chronic liver disease can receive an EGD for ruling out portal hypertensive gastropathy, an EUS to assess the bile duct, gallbladder, and liver, a shear wave assessment of the liver, an EUS-guided portal pressure evaluation, and finally, a liver biopsy. The speaker emphasizes the safety and efficacy of EUS-guided liver biopsy, recommending the use of a 19-gauge FNB needle for optimal results. They also discuss the technique for EUS-guided portal pressure measurement, highlighting the importance of avoiding inadvertent splenic biopsy and the potential for future advancements in wireless tracing for transjugular measurements. The speaker concludes by touching on endoscopic treatment of gastric varices, specifically the use of glue and coiling techniques. They note that the treatment is currently limited to highly experienced specialists and relies on the identification of feeder vessels. However, the speaker also mentions the potential for non-variceal EUS-guided hemostasis using glue injections. Overall, the presentation provides an overview of the latest advancements in endohepatology and highlights the benefits and techniques associated with EUS-guided procedures.

Asset Subtitle

David L. Diehl, MD, FASGE

Keywords

endohepatology

liver biopsy

portal pressure measurement

endoscopic treatment

gastric varices

endoscopic ultrasound

chronic liver disease

EUS-guided liver biopsy

19-gauge FNB needle