Perspective in endoscopic technology in the management of patients with portal hypertension
10.12025/j.issn.1008-6358.2024.20240605
- VernacularTitle:内镜技术在门静脉高压中的应用展望
- Author:
Xiaoquan HUANG
1
;
Shiyao CHEN
Author Information
1. 复旦大学附属中山医院消化科,上海 200032;复旦大学循证医学中心,上海 200032
- Keywords:
portal hypertension;
cirrhosis;
endoscopic treatment;
esophagogastric varices;
ultrasound endoscopy
- From:
Chinese Journal of Clinical Medicine
2024;31(3):343-346
- CountryChina
- Language:Chinese
-
Abstract:
Endoscopic ligation,sclerotherapy and injection of tissue glue combined with medicine treatment have replaced surgical shunt and devascularization as the first-line treatment recommended by guidelines for esophagogastric variceal bleeding in patients with cirrhosis and portal hypertension.However,some of the variceal bleeding induced by non-cirrhotic portal hypertension.Comorbidities such as diabetes,portal vein thrombosis,liver tumors,and hepatic artery-portal vein fistulas have reduced the efficacy of endoscopic treatment,and have increased the rate of complication such as ectopic embolism.Traditional endoscopic techniques are facing substantial challenges.The urgent needs for precise injection techniques,complete variceal obliteration,and the prevention of ectopic embolism have become apparent.The era of precision medicine in variceal endoscopic treatment has been ushered in by advancements such as preoperative assessments using computed tomography(CT)and ultrasound endoscopy,ultrasound-guided tissue glue injection with spring coil assistance,and immediate postoperative ultrasound endoscopic evaluation.This progress is anticipated to overcome the diagnostic and therapeutic limitations associated with non-cirrhotic portal hypertension.Integrating CT imaging virtual simulation and other technological innovations,to surpass conventional interventional techniques,is helpful of achieving a comprehensive endoscopic approach to the diagnosis and treatment of portal hypertension.
