Endoscopy plays a vital role in the management of patients with hepatobiliary diseases. The role of endoscopy in management of gastroesophageal varices, in prevention of bleeding and control of active bleeding is well established. Newer modalities of endotherapy such as hemospray and metal stent for refractory variceal bleed are emerging. Gastric antral vascular ectasias and portal hypertensive gastropathy can be diagnosed and treated with endoscopy. Capsule endoscopy and device assisted enteroscopy has revolutionized concepts of small bowel evaluation for obscure GI bleed. Apart from this roles, ERCP can be used to treat post liver transplant biliary complications with safety and efficacy. Though, there are higher adverse events of ERCP in patients with advanced liver diseases, it is more safe than surgical alternative in patients with cirrhosis having pancreatobiliary diseases. In the patients with PSC, ERCP can be used to diagnose and treat significant stricture, to rule out cholangiocarcinoma. Bariatric endoscopy has definitive role in weight loss required to treat NASH, however this area need to be studied further.
KeywordsEndoscopy Liver cirrhosis Esophageal varices Gastric varices Post liver transplant biliary complications Bariatric and metabolic endoscopy
- 11.Gluud LL, Krag A. Banding ligation versus beta-blockers for primary prevention in oesophageal varices in adults. Cochrane Database Syst Rev. 2012;(8):CD004544.Google Scholar
- 19.Nitin Jagtap, Zaheer Nabi, Manu Tandan, Mohan Ramchandani, Mithun Sharma, Sundeep Lakhtakia, P.N. Rao, Rajesh Gupta, Rakesh Kalapala, Jahangeer Basha, Santosh Darishetty, G.V. Rao, D.N. Reddy, (2019) Is It Safe to Perform Endoscopic Retrograde Cholangiopancreatography in Decompensated Cirrhosis?. Journal of Clinical and Experimental HepatologyGoogle Scholar
- 20.European Society of Gastrointestinal Endoscopy and European Association for the Study of the Liver. Role of endoscopy in primary sclerosing cholangitis: European Society of Gastrointestinal Endoscopy (ESGE) and European Association for the Study of the Liver (EASL) clinical guideline. J Hepatol. 2017;66:1265–81.CrossRefGoogle Scholar