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World J Hepatol. Nov 27, 2021; 13(11): 1459-1483
Published online Nov 27, 2021. doi: 10.4254/wjh.v13.i11.1459
Role of endoscopic ultrasound in the field of hepatology: Recent advances and future trends
Jahnvi Dhar, Jayanta Samanta
Jahnvi Dhar, Jayanta Samanta, Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Dhar J contributed conception and design, data acquisition and analysis, drafted the article, final approval; Samanta J contributed conception and design, data interpretation, critical revision and intellectual content of the draft, final approval.
Conflict-of-interest statement: All the authors declare no potential conflicts of interest.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jayanta Samanta, MBBS, MD, DM, Assistant Professor, Doctor, Department of Gastroenterology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. dj_samanta@yahoo.co.in
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: July 18, 2021
Revised: July 19, 2021
Accepted: September 3, 2021
Article in press: September 3, 2021
Published online: November 27, 2021
Abstract

The role of endoscopic ultrasound (EUS) as a diagnostic and therapeutic modality for the management of various gastrointestinal diseases has been expanding. The imaging or intervention for various liver diseases has primarily been the domain of radiologists. With the advances in EUS, the domain of endosonologists is rapidly expanding in the field of hepatology. The ability to combine endoscopy and sonography in one hybrid device is a unique property of EUS, together with the ability to bring its probe/transducer near the liver, the area of interest. Its excellent spatial resolution and ability to provide real-time images coupled with several enhancement techniques, such as contrast-enhanced (CE) EUS, have facilitated the growth of EUS. The concept of “Endo-hepatology” encompasses the wide range of diagnostic and therapeutic procedures that are now gradually becoming feasible for managing various liver diseases. Diagnostic advancements can enable a wide array of techniques from elastography and liver biopsy for liver parenchymal diseases, to CE-EUS for focal liver lesions to portal pressure measurements for managing various liver conditions. Similarly, therapeutic advancements range from EUS-guided eradication of varices, drainage of bilomas and abscesses to various EUS-guided modalities of liver tumor management. We provide a comprehensive review of all the different diagnostic and therapeutic EUS modalities available for the management of various liver diseases. A synopsis of all the technical details involving each procedure and the available data has been tabulated, and the future trends in this area have been highlighted.

Keywords: Endoscopic ultrasound, Liver disease, Elastography, Varices, Liver tumor, Liver biopsy

Core Tip: The advancements in the field of endoscopic ultrasound (EUS) have enabled endosonologists to rapidly expand their wings in the field of hepatology. “Endo-hepatology” encompasses the wide range of diagnostic and therapeutic endoscopic procedures that can be used for the management of various liver diseases. Diagnostic advancements range from elastography for liver parenchymal diseases, contrast-enhanced EUS for a focal liver lesion to portal pressure measurements. Therapeutic advancements range from EUS-guided eradication of varices to drainage of abscesses to liver tumor ablation. In this comprehensive review, all the various diagnostic and therapeutic EUS modalities available for the management of liver diseases have been detailed.