Current Issue

February 2022

The Evolving Role of Therapeutic Endoscopy in Patients with Chronic Liver Diseases
Edited by Andres F. Carrion

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. ERCP evolved from a diagnostic to a therapeutic intervention, and ongoing improvements of accessories and novel devices continue to pave the road for increased therapeutic capabilities, even in highly complex cases. Biliary complications, once considered the Achilles heel of liver transplantation, can nowadays be treated successfully with ERCP in most patients. Balloon dilatation and incremental plastic stenting has been the treatment of choice for anastomotic biliary strictures in liver transplant recipients, obviating surgical reintervention. Novel therapeutic strategies, such as sequential plastic stent addition and using fully covered self-expandable metal stents, offer attractive alternatives to frequent plastic stent replacement with comparable outcomes. Single-operator cholangioscopy has dramatically improved over the past decade and now offers digital imaging on an extremely versatile platform, which has greatly increased the diagnostic yield of ERCP in the evaluation of biliary strictures by permitting accurate evaluation of vascular patterns in addition to providing image-guided sampling and therapeutic capabilities.

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About the Journal

A perfect source to consult for those in the fields of gastroenterology and hepatology, Clinics in Liver Disease provides answers to clinical questions, information on the latest diagnostic methods and treatments, and numerous clinical images. Published quarterly—in February, May, August, and November—each issue offers in-depth reviews that focus on the liver and biliary system.