Preface
The relationship between the kidney and the liver in disease is important for clinicians to recognize and understand. Liver disease, both mild and especially cirrhosis of any cause, can lead to the development of kidney disease. Chronic hepatitis B and C can lead to the development of significant glomerular disease. The presence of portal hypertension and ascites can lead to vasoconstriction of the renal vessels, causing hepatorenal syndrome, which can rapidly lead to renal failure and the need for renal replacement therapy. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - April 1, 2022 Category: Gastroenterology Authors: David Bernstein Source Type: research
Hepatorenal Syndrome
Hepatorenal syndrome (HRS) is defined as a functional renal failure without major histologic changes in individuals with severe liver disease and it is associated with a high mortality rate. Renal hypoperfusion due to marked vasoconstriction as a result of complex circulatory dysfunction has been suggested to be the cornerstone of HRS. Splanchnic and peripheral arterial vasodilation and cirrhotic cardiomyopathy result in effective arterial hypovolemia and compensatory activation of vasoconstrictor mechanisms. The efficacy of current therapeutic strategies targeting this circulatory dysfunction is limited. Increasing eviden...
Source: Clinics in Liver Disease - March 30, 2022 Category: Gastroenterology Authors: Timea Csak Source Type: research
Improving Diagnostic Yield in Indeterminate Biliary Strictures
Indeterminate biliary strictures are defined as a narrowing of the bile duct that cannot be differentiated as malignant or benign after performing cross-sectional imaging and an ERCP. Identifying the etiology of a bile duct stricture is the single most important step in determining whether a complex and potentially morbid surgical resection is warranted. Due to this diagnostic and therapeutic dilemma, new technologies, laboratory tests, and procedures are emerging to solve this problem. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 19, 2021 Category: Gastroenterology Authors: David J. Restrepo, Chris Moreau, Cyrus V. Edelson, Ameesh Dev, Shreyas Saligram, Hari Sayana, Sandeep N. Patel Source Type: research
Endoscopic Ultrasound-Guided Liver Biopsy
Endoscopic ultrasound-guided liver biopsy (EUS-LB) has emerged as a safe and effective alternative to percutaneous and trans-jugular approaches for hepatic tissue acquisition. It has shown superior diagnostic yield for the targeted approach of focal lesions, less sampling variability, improved patient comfort, and safety profile. These advantages have contributed to the increased use of EUS-LB as a technique for obtaining liver tissue. In this review, we provide an update on the recent evidence of EUS-LB for the evaluation of liver disease. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 19, 2021 Category: Gastroenterology Authors: Ishaan K. Madhok, Nasim Parsa, Jose M. Nieto Source Type: research
Endoscopic Ultrasound Evaluation of Portal Pressure
Portal hypertension is a complex syndrome with multiple clinical manifestations that develop in a variety of conditions and diseases. The spectrum of portal hypertension manifestations is wide and dependent on the physiologic site of increased portal resistance (pre-, post-, and sinusoidal or intrahepatic), as well as the presence of hepatocellular dysfunction. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 19, 2021 Category: Gastroenterology Authors: Enrico O. Souto Source Type: research
The Evolving Role of Therapeutic Endoscopy in Patients with Chronic Liver Diseases
CLINICS IN LIVER DISEASE (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 19, 2021 Category: Gastroenterology Authors: Andres F. Carrion Source Type: research
Copyright
Elsevier (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 19, 2021 Category: Gastroenterology Source Type: research
Contributors
NORMAN GITLIN, MD, FRCP (LONDON), FRCPE (EDINBURGH), FAASLD, FACP, FACG (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 19, 2021 Category: Gastroenterology Source Type: research
Contents
Andres F. Carrion (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 19, 2021 Category: Gastroenterology Source Type: research
Forthcoming Issues
The Liver and Renal Disease (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - November 19, 2021 Category: Gastroenterology Source Type: research
Role of Endoscopic Retrograde Cholangiopancreatography in the Diagnosis and Management of Cholestatic Liver Diseases
Cholestatic liver diseases (CLDs) occur as a result of bile duct injury, emanating into duct obstruction and bile stasis. Advances in radiological imaging in the last decade has replaced endoscopic retrograde cholangiopancreatography (ERCP) as the first diagnostic tool, except in certain groups of patients, such as those with ischemic cholangiopathy (IsC) or early stages of primary sclerosing cholangitis (PSC). ERCP provides an opportunity for targeted tissue acquisition for histopathological evaluation and carries a diverse therapeutic profile to restore bile flow. The aim of this review article is to appraise the diagnos...
Source: Clinics in Liver Disease - October 25, 2021 Category: Gastroenterology Authors: Tara Keihanian, Monique T. Barakat, Sooraj Tejaswi, Rajnish Mishra, Christopher J. Carlson, John J. Brandabur, Mohit Girotra Source Type: research
Management of Biliary Complications in Liver Transplant Recipients
Biliary complications are often referred to as the Achilles ’ heel of liver transplantation (LT). The most common of these complications include strictures, and leaks. Prompt diagnosis and management is key for preservation of the transplanted organ. Unfortunately, a number of factors can lead to delays in diagnosis and make adequate treatment a challenge. Innovations in advanced endoscopic techniques have increased non-surgical options for these complications and in many cases is the preferred approach. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - October 25, 2021 Category: Gastroenterology Authors: Justin J. Forde, Kalyan Ram Bhamidimarri Source Type: research
Endoscopic Ultrasound for the Diagnosis and Staging of Biliary Malignancy
Cholangiocarcinoma (CCA) is the most common neoplasm of the biliary tract. The biological behavior and prognosis of CCA vary depending on the tumor's location in the biliary tree, dictating a different diagnostic, and treatment approach. Establishing a diagnosis of CCA remains a challenge and up to 20% of biliary strictures can yield indeterminate results, despite extensive evaluation. Endoscopic ultrasound (EUS) has become an effective diagnostic tool, as it provides high-quality images of the bile duct and allows for the sampling of strictures in the same plane of view. In this chapter, we explore the utility of EUS as a...
Source: Clinics in Liver Disease - October 25, 2021 Category: Gastroenterology Authors: Martin Coronel, Jeffrey H. Lee, Emmanuel Coronel Source Type: research
Polypectomy, Endoscopic Mucosal Resection, and Endoscopic Submucosal Dissection in the Cirrhotic Population
This article also discusses experts' opinions on approaches taken to perform these procedures with acceptable risks. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - October 25, 2021 Category: Gastroenterology Authors: Ahmad Nakshabandi, Manasi Rungta, Mohamed O. Othman Source Type: research
Through the Scope Hepatobiliary Interventions in Patients with Liver Diseases: Minimizing Risks and Improving Outcomes
The use of advanced endoscopic techniques in the field of hepatology has rapidly expanded over the last decade. Traditionally, endoscopy in patients with chronic liver disease was limited to screening/surveillance of gastroesophageal varices and colorectal polyps as well as endoscopic interventions for prophylaxis and treatment of acute variceal hemorrhage. Interventions such as endoscopic retrograde cholangiopancreatography (ERCP) have become standard of care for various hepatobiliary disorders and permit minimally invasive management, reducing the need for surgical and percutaneous interventions. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - October 25, 2021 Category: Gastroenterology Authors: Andres F. Carrion Tags: Preface Source Type: research
