肝病内镜治疗进展：不仅仅是治疗静脉曲张。
Update of endoscopy in liver disease: more than just treating varices.
机构信息
Centre for Liver and Digestive Disorders, The Royal Infirmary, University of Edinburgh, Edinburgh EH16 4SA, United Kingdom.
出版信息
World J Gastroenterol. 2012 Feb 7;18(5):401-11. doi: 10.3748/wjg.v18.i5.401.
Abstract
The management of complications in liver disease is often complex and challenging. Endoscopy has undergone a period of rapid expansion with numerous novel and specialized endoscopic modalities that are of increasing value in the investigation and management of the patient with liver disease. In this review, relevant literature search and expert opinions have been used to provide a brief overview and update of the current endoscopic management of patients with liver disease and portal hypertension. The main areas covered are safety of endoscopy in patients with liver disease, the use of standard endoscopy for the treatment of varices and the role of new endoscopic modalities such as endoscopic ultrasound, esophageal capsule, argon plasma coagulation, spyglass and endomicroscopy in the investigation and treatment of liver-related gastrointestinal and biliary pathology. It is clear that the role of the endoscopy in liver disease is well beyond that of just treating varices. As the technology in endoscopy expands, so does the role of the endoscopist in liver disease.
摘要
肝脏疾病并发症的管理通常较为复杂和具有挑战性。内镜技术经历了快速发展阶段，出现了许多新的专门内镜技术，这些技术在肝病患者的诊断和管理中具有越来越高的价值。在本综述中，采用相关文献检索和专家意见，简要概述和更新了目前肝脏疾病和门静脉高压患者的内镜治疗方法。主要涵盖的领域包括：肝病患者内镜检查的安全性，标准内镜治疗静脉曲张，以及超声内镜、食管胶囊内镜、氩等离子凝固术、胆道镜和内镜显微镜等新技术在肝脏相关胃肠道和胆道病变诊断和治疗中的作用。显然，内镜在肝脏疾病中的作用不仅仅局限于治疗静脉曲张。随着内镜技术的发展，内镜医生在肝脏疾病中的作用也在不断扩大。
相似文献
1
Update of endoscopy in liver disease: more than just treating varices.肝病内镜治疗进展：不仅仅是治疗静脉曲张。
World J Gastroenterol. 2012 Feb 7;18(5):401-11. doi: 10.3748/wjg.v18.i5.401.
2
Endoscopic variceal ligation in pediatric patients with portal hypertension secondary to liver cirrhosis.肝硬化继发门静脉高压症患儿的内镜下静脉曲张结扎术
Gastrointest Endosc. 1997 Sep;46(3):244-6. doi: 10.1016/s0016-5107(97)70094-4.
3
Esophageal capsule endoscopy for screening and surveillance of esophageal varices in patients with portal hypertension.食管胶囊内镜用于门静脉高压患者食管静脉曲张的筛查和监测。
Hepatology. 2008 May;47(5):1595-603. doi: 10.1002/hep.22227.
4
Remaining challenges for the noninvasive diagnosis of esophageal varices in liver cirrhosis.肝硬化食管静脉曲张非侵入性诊断的遗留挑战。
Esophagus. 2020 Jan;17(1):19-24. doi: 10.1007/s10388-019-00699-4. Epub 2019 Oct 16.
5
[Value of endoscopic ultrasound in early diagnosis of gastroesophageal varices in patients with liver cirrhosis].[内镜超声在肝硬化患者食管胃静脉曲张早期诊断中的价值]
Zhonghua Gan Zang Bing Za Zhi. 2016 Sep 20;24(9):671-675. doi: 10.3760/cma.j.issn.1007-3418.2016.09.007.
6
Management of esophageal varices in children by endoscopic variceal ligation.儿童食管静脉曲张的内镜下套扎治疗
J Pediatr Surg. 1996 Aug;31(8):1056-9. doi: 10.1016/s0022-3468(96)90086-x.
7
Comparison of hepatic venous pressure gradient and endoscopic grading of esophageal varices.肝静脉压力梯度与食管静脉曲张内镜分级的比较。
World J Gastroenterol. 2016 Mar 21;22(11):3212-9. doi: 10.3748/wjg.v22.i11.3212.
8
Hemodynamic analysis of esophageal varices in patients with liver cirrhosis using color Doppler ultrasound.利用彩色多普勒超声对肝硬化患者食管静脉曲张进行血流动力学分析。
World J Gastroenterol. 2005 Aug 7;11(29):4560-5. doi: 10.3748/wjg.v11.i29.4560.
9
The relationship of endoscopy, portal Doppler ultrasound flowmetry, and clinical and biochemical tests in cirrhosis.内镜检查、门静脉多普勒超声血流测定与肝硬化临床及生化检查之间的关系
J Hepatol. 1994 Jan;20(1):11-8. doi: 10.1016/s0168-8278(05)80461-1.
10
Prophylactic endoscopic sclerotherapy in patients with liver cirrhosis, portal hypertension, and esophageal varices.肝硬化、门静脉高压和食管静脉曲张患者的预防性内镜硬化治疗。
Hepatogastroenterology. 1997 May-Jun;44(15):625-36.
引用本文的文献
1
Alterations in Intestinal Mucosal Barrier Visualized by Confocal Laser Endomicroscopy in Liver Cirrhosis: A Pilot Trial (AMBIC).肝硬化患者肠道黏膜屏障改变的共聚焦激光内镜可视化研究：一项试点试验（AMBIC）
Diagnostics (Basel). 2024 Jul 25;14(15):1606. doi: 10.3390/diagnostics14151606.
2
Systematic review with meta-analysis: incidence of variceal hemorrhage in patients with cirrhosis undergoing transesophageal echocardiography.系统评价与荟萃分析：接受经食管超声心动图检查的肝硬化患者发生静脉曲张出血的发生率
Aliment Pharmacol Ther. 2022 May;55(9):1088-1098. doi: 10.1111/apt.16860. Epub 2022 Mar 28.
3
Gastrointestinal endoscopy in cirrhotic patient: Issues on the table.肝硬化患者的胃肠内镜检查：有待探讨的问题。
World J Gastrointest Endosc. 2021 Jul 16;13(7):210-220. doi: 10.4253/wjge.v13.i7.210.
4
Lateral position intubation followed by endoscopic ultrasound-guided angiotherapy in acute esophageal variceal rupture: A case report.急性食管静脉曲张破裂时侧卧位插管后行内镜超声引导下血管治疗：一例报告
World J Clin Cases. 2021 Jan 16;9(2):372-378. doi: 10.12998/wjcc.v9.i2.372.
5
Transesplenic access in the treatment of varicose gastrointestinal bleeding. Case and technical report.经脾途径治疗胃肠道静脉曲张出血。病例与技术报告。
Einstein (Sao Paulo). 2020 Jan 27;18:eRC4934. doi: 10.31744/einstein_journal/2020RC4934. eCollection 2020.
6
Efficacy of capsule endoscopy in patients with cirrhosis for the diagnosis of upper gastrointestinal lesions and small bowel abnormalities: a study protocol for prospective interventional study.胶囊内镜在肝硬化患者中诊断上消化道病变和小肠异常的疗效：一项前瞻性干预性研究的研究方案
BMJ Open Gastroenterol. 2017 Sep 14;4(1):e000168. doi: 10.1136/bmjgast-2017-000168. eCollection 2017.
7
Endoscopy management algorithms: role of cyanoacrylate glue injection and self-expanding metal stents in acute variceal haemorrhage.内镜治疗管理算法：氰基丙烯酸酯胶注射和自膨式金属支架在急性静脉曲张出血中的作用
Frontline Gastroenterol. 2015 Jul;6(3):208-216. doi: 10.1136/flgastro-2013-100428. Epub 2014 Jun 23.
8
Upper gastrointestinal bleeding in cirrhosis: varix or no varix?肝硬化患者的上消化道出血：有无静脉曲张？
BMJ Case Rep. 2013 Jul 29;2013:bcr2013008815. doi: 10.1136/bcr-2013-008815.
本文引用的文献
1
Sub-clinical hepatic encephalopathy in cirrhotic patients is not aggravated by sedation with propofol compared to midazolam: a randomized controlled study.与咪达唑仑相比，丙泊酚镇静不会加重肝硬化患者的亚临床肝性脑病：一项随机对照研究。
J Hepatol. 2011 Jan;54(1):72-7. doi: 10.1016/j.jhep.2010.06.023. Epub 2010 Aug 22.
2
Revising consensus in portal hypertension: report of the Baveno V consensus workshop on methodology of diagnosis and therapy in portal hypertension.门静脉高压共识的修订：巴韦诺V门静脉高压诊断与治疗方法共识研讨会报告
J Hepatol. 2010 Oct;53(4):762-8. doi: 10.1016/j.jhep.2010.06.004. Epub 2010 Jun 27.
3
Contrast-enhanced ultrasound for the evaluation of hepatic artery stenosis after liver transplantation: potential role in changing the clinical algorithm.对比增强超声在肝移植后肝动脉狭窄评估中的应用：改变临床算法的潜在作用。
Liver Transpl. 2010 Jun;16(6):729-35. doi: 10.1002/lt.22054.
4
Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002).结直肠癌筛查和监测指南（中高危人群）（2002 年更新）。
Gut. 2010 May;59(5):666-89. doi: 10.1136/gut.2009.179804.
5
Management of varices and variceal hemorrhage in cirrhosis.肝硬化中静脉曲张及静脉曲张出血的管理
N Engl J Med. 2010 Mar 4;362(9):823-32. doi: 10.1056/NEJMra0901512.
6
The role of carvedilol in the management of portal hypertension.卡维地洛在门静脉高压症管理中的作用。
Eur J Gastroenterol Hepatol. 2010 Aug;22(8):905-11. doi: 10.1097/MEG.0b013e3283367a99.
7
A self-expanding metal stent for complicated variceal hemorrhage: experience at a single center.自膨式金属支架治疗复杂静脉曲张出血：单中心经验。
Gastrointest Endosc. 2010 Jan;71(1):71-8. doi: 10.1016/j.gie.2009.07.028. Epub 2009 Oct 30.
8
Portal hypertensive colopathy is associated with portal hypertension severity in cirrhotic patients.门脉高压性结肠病与肝硬化患者的门脉高压严重程度相关。
World J Gastroenterol. 2009 Oct 14;15(38):4781-7. doi: 10.3748/wjg.15.4781.
9
Direct peroral cholangioscopy using an ultra-slim upper endoscope for the treatment of retained bile duct stones.使用超薄上消化道内窥镜进行直接经口胆管镜检查治疗残留胆管结石。
Am J Gastroenterol. 2009 Nov;104(11):2729-33. doi: 10.1038/ajg.2009.435. Epub 2009 Jul 21.
10
Randomized controlled trial of carvedilol versus variceal band ligation for the prevention of the first variceal bleed.卡维地洛与静脉曲张套扎术预防首次静脉曲张出血的随机对照试验
Hepatology. 2009 Sep;50(3):825-33. doi: 10.1002/hep.23045.
Zotero 插件