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Portal Hypertension · Journal article
Den Open · August 13, 2026
A consensus or society position rather than new primary data.
This is a narrative review of endo-hepatology, a collaborative endoscopic and hepatological approach to portal hypertension and hepatobiliary diseases, published in 2027. The review synthesizes diagnostic and therapeutic EUS-based applications including portal pressure measurement, liver biopsy, variceal assessment, and vascular intervention, but does not report efficacy or safety data from a controlled trial. It provides current conceptual frameworks and clinical applications rather than evidence of treatment superiority.
Narrative review. Patients with portal hypertension and chronic liver disease requiring diagnostic or therapeutic endoscopic evaluation. Japan and Spain (author affiliations).
EUS-PPGM (EUS-guided portal pressure gradient measurement) enables direct, minimally invasive portal pressure measurement and correlates strongly with hepatic venous pressure gradient (HVPG) EUS-guided liver biopsy provides diagnostic accuracy comparable to percutaneous biopsy with less post-procedure pain EUS-guided coil plus cyanoacrylate injection has demonstrated favorable efficacy and safety for gastric varices
No primary endpoint data from controlled trials; clinical outcomes (bleeding control, mortality, morbidity) are not reported Text is truncated; complete efficacy and safety data for procedures are not available
This review outlines an integrated, minimally invasive endoscopic approach to portal hypertension management that may reduce morbidity compared to percutaneous or radiological alternatives. However, it does not provide trial-level evidence of superiority and should be read as a conceptual and technical overview guiding procedural selection, not as proof of clinical benefit.
A comprehensive review article synthesizing current concepts and recent developments in endo-hepatology without reporting original trial data, comparative efficacy, or outcome statistics from a single study.
As stated by the source record.
Quoted from the source exactly as published.
This review outlines an integrated, minimally invasive endoscopic approach to portal hypertension management that may reduce morbidity compared to percutaneous or radiological alternatives. However, it does not provide trial-level evidence of superiority and should be read as a conceptual and technical overview guiding procedural selection, not as proof of clinical benefit.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Endo-hepatology is a rapidly evolving field encompassing endoscopic diagnosis and treatment of hepatobiliary diseases, primarily using endoscopic ultrasound (EUS). Since its conceptualization in 2012, the field has expanded dramatically alongside advances in interventional EUS. A landmark 2024 review broadened the concept to include endoscopic management of hepatobiliary diseases using interventional EUS/endoscopic retrograde cholangiopancreatography and advanced imaging technologies. In portal hypertension (PH), diagnostic applications include EUS-based variceal hemodynamic assessment, EUS-guided shear wave elastography, EUS-guided porto-systemic pressure gradient measurement (EUS-PPGM), EUS-guided liver biopsy (EUS-LB), and portal vein sampling. Therapeutic applications include EUS-guided vascular embolization for gastric, esophageal, and ectopic varices; portosystemic shunt obliteration for refractory hepatic encephalopathy; radiofrequency ablation of hepatocellular carcinoma; and emerging procedures such as intrahepatic portosystemic shunt creation and portal vein stenting. EUS-PPGM enables direct, minimally invasive portal pressure measurement and correlates strongly with the hepatic venous pressure gradient (HVPG). It may offer particular advantages in pre-sinusoidal PH, such as porto-sinusoidal vascular disorder, and in conditions with mixed sinusoidal and presinusoidal components, including metabolic dysfunction-associated steatotic liver disease, where HVPG may underestimate portal pressure. The "one-stop" concept integrates portal pressure measurement, LB, liver stiffness assessment, and variceal evaluation and treatment within a single endoscopic session. EUS-guided coil plus cyanoacrylate injection has demonstrated favorable efficacy and safety for gastric varices, while EUS-LB provides diagnostic accuracy comparable to percutaneous biopsy with less post-procedure pain. By integrating diagnostic and therapeutic procedures, endo-hepatology bridges endoscopy and hepatology and may provide comprehensive, minimally invasive, and personalized management of PH and chronic liver disease.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.