Endoscopic Ultrasound-Guided Biliary Interventions in Liver Disease
If endoscopic retrograde cholangiopancreatography (ERCP) fails in cases of biliary obstruction and jaundice, percutaneous drains have been traditionally the current second-line option. Endoscopic ultrasonography-guided biliary drainage (EUS-BD) with choledocoduodenostomy or hepaticogastrostomy is alternative modality that have shown equivalent or better technical and clinical success compared with percutaneous drainage. Similarly, EUS-guided gallbladder drainage has emerged as a therapeutic option in acute cholecystitis as well. Furthermore, EUS-BD avoids some of the pitfalls of percutaneous drainage. Current research in E...
Source: Clinics in Liver Disease - October 21, 2021 Category: Gastroenterology Authors: Shyam Vedantam, Sunil Amin Source Type: research
Endoscopic Treatment of Gastric and Ectopic Varices
Gastric variceal bleeding has a high mortality. Endoscopic cyanoacrylate injection is the standard therapy; however, rebleeding and unexpected adverse events, such as injection sites ulcers and distal glue embolisms, are pitfalls of this therapy. Endoscopic ultrasound (EUS)-guided endovascular therapies offer a safer and more practical alternative for the treatment of gastric varices. EUS-guided combined therapy with coiling and cyanoacrylate injection is the most promising alternative with high obliteration rates and fewer adverse events reported. The authors reviewed the latest available data for all endoscopic therapies...
Source: Clinics in Liver Disease - October 20, 2021 Category: Gastroenterology Authors: Roberto Oleas, Carlos Robles-Medranda Source Type: research
Novel Therapies That May Cure Chronic Hepatitis B Virus
The hepatitis B virus (HBV) is a member of the Hepadnaviridae family, which includes small DNA enveloped viruses that infect primates, rodents, and birds and is the causative factor of chronic hepatitis B. A common feature of all these viruses is their great specificity by species and cell type, as well as a peculiar genomic and replication organization similar to that of retroviruses. The HBV virion consists of an external lipid envelope and an internal icosahedral protein capsid containing the viral genome and a DNA polymerase, which also functions as a reverse transcriptase. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 28, 2021 Category: Gastroenterology Authors: Alessandro Loglio, Mauro Vigan ò, Pietro Lampertico Source Type: research
Challenging Issues in the Management of Chronic Hepatitis B Virus
CLINICS IN LIVER DISEASE (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 28, 2021 Category: Gastroenterology Authors: Mitchell L. Shiffman Source Type: research
Copyright
Elsevier (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 28, 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 - September 28, 2021 Category: Gastroenterology Source Type: research
Contents
Mitchell L. Shiffman (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 28, 2021 Category: Gastroenterology Source Type: research
Forthcoming Issues
The Evolving Role of Therapeutic Endoscopy in Patients with Chronic Liver Diseases (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 28, 2021 Category: Gastroenterology Source Type: research
Endoscopic Treatment of Esophageal Varices
Acute variceal bleeding is a complication of portal hypertension, usually due to cirrhosis, with high morbidity and mortality. There are 3 scenarios for endoscopic treatment of esophageal varices: prevention of first variceal bleed, treatment of active variceal bleed, and prevention of rebleeding. Patients with cirrhosis should be screened for esophageal varices. Recommended endoscopic therapy for acute variceal bleeding is endoscopic variceal banding. Although banding is the first-choice treatment, sclerotherapy may have a role. Treatment with Sengstaken-Blakemore tube or self-expanding covered metallic esophageal stent c...
Source: Clinics in Liver Disease - September 25, 2021 Category: Gastroenterology Authors: Marc J. Zuckerman, Sherif Elhanafi, Antonio Mendoza Ladd Source Type: research
Management of Thrombocytopenia and Coagulopathy in Patients with Chronic Liver Disease Undergoing Therapeutic Endoscopic Interventions
Management of coagulopathy in patients with advanced liver disease undergoing therapeutic endoscopic procedures is complex. Improvements in the understanding of hemostasis at a physiologic level have highlighted the inaccuracy of currently available clinical tests, like platelet count and prothrombin time, in estimating hemostasis in patients with cirrhosis. With identification of novel factors that contribute to bleeding risk in patients with cirrhosis, there is a dearth of clinical trial data that account for all potentially relevant factors and that examine interventions to reduce bleeding risk. Precise recommendations ...
Source: Clinics in Liver Disease - September 16, 2021 Category: Gastroenterology Authors: Jay Luther, Lawrence S. Friedman Source Type: research
Endoscopic Bariatric Interventions in Patients with Chronic Liver Disease
Obesity and its associated comorbidities are rapidly increasing in the US population. Therefore, metabolic associated fatty liver disease (MAFLD), previously known as nonalcoholic fatty liver disease (NAFLD), has become a leading indication for liver transplantation. Lifestyle modifications as a sole therapy have been insufficient to reduce the burden of chronic liver disease secondary to MAFLD. Endoscopic bariatric interventions (EBI) appear to be safe and effective therapies for obesity and chronic liver disease secondary to MAFLD. Gastric EBI include endoscopic sleeve gastroplasty (ESG) and intragastric balloons (IGB). ...
Source: Clinics in Liver Disease - September 16, 2021 Category: Gastroenterology Authors: Marco A. Bustamante-Bernal, Luis O. Chavez, Marc J. Zuckerman Source Type: research
Hepatitis B and Health Care Workers
Owing to standard precautions and initiatives for universal hepatitis B virus (HBV) vaccination in the general population and health care workers, risk of transmission of HBV infection from the patient to a health care worker (and vice versa) is very low. The need for mandatory HBV screening and vaccination in health care workers is less clear than in the past. Health care workers with chronic HBV infection neither require restrictions on professional practice nor disclosure of infection status to a patient. Further study is required to develop effective revaccination strategies to manage health care workers who are vaccin...
Source: Clinics in Liver Disease - September 10, 2021 Category: Gastroenterology Authors: Stephen C. Pappas Source Type: research
Interpretation of HBV Serologies
Hepatitis B was discovered by researchers who were investigating jaundice associated with blood transfusions as well as parenterally administered medications. Through trial and error, the HBV was identified. There are specific tests that detect HBV infection, whether it is a previous exposure or active infection. The various HBV serologies are reviewed in this work as well. Hepatitis B surface antigen has emerged as a tool in defining treatment endpoint and its significance is reviewed. HBV genotypes are distributed uniquely throughout the world, in particular, genotype C is associated with higher rates of hepatocellular c...
Source: Clinics in Liver Disease - September 10, 2021 Category: Gastroenterology Authors: Philippe J. Zamor, Ashley M. Lane Source Type: research
The Changing Demographics of Hepatitis B Virus Infection
Hepatitis B virus infection remains a global public health problem with changing epidemiology due to several factors including vaccination policies and migration. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 9, 2021 Category: Gastroenterology Authors: Issam Tout, Dimitri Loureiro, Tarik Asselah Source Type: research
Treatment and Prevention of Acute Hepatitis B Virus
This article reviews the incidence of acute hepatitis B virus (HBV) infection, its clinical course, strategies to prevent acute HBV infection in susceptible individuals, and the management of patients with acute HBV. (Source: Clinics in Liver Disease)
Source: Clinics in Liver Disease - September 9, 2021 Category: Gastroenterology Authors: Simone E. Dekker, Ellen W. Green, Joseph Ahn Source Type: research
