Index Note: Page numbers of article titles are in boldface type. A Acute variceal bleeding management of, 251 262 balloon tamponade of esophagus in, 257 258 endoscopic therapies in, 255 257. See also Endoscopy, in acute variceal bleeding management. failure in, 258 259 general measures in, 253 254 vasoconstrictors in, 254 255 refractory, 297 305 treatment failures defined, 298 rescue therapies for, 298 300 balloon tamponade, 298 299 in high-risk patients, 300 302 surgery, 299 TIPS, 299 302 Antibiotic(s), in dominant stenoses management, 354 Aspiration, fine-needle, in HCC diagnosis, 327 331 B Balloon dilatation, in dominant stenoses management, 352 353 Balloon tamponade, of esophagus, in acute variceal bleeding management, 257 258 Benzodiazepine(s), metabolism of, hepatic dysfunction and, 186 Biliary casts, after liver transplantation, 367 Biliary leaks, after liver transplantation, 365 367 Biliary sludge, after liver transplantation, 367 Biliary stones, after liver transplantation, 367 Biliary strictures anastomotic strictures, 363 364 causes of, 362 365 nonanastomotic strictures, 365 types of, 362 365 Bleeding, variceal after portal hypertension management, risk factors for, EUS in assessment of, 225 226 endoscopic sedation of patients with, 192 esophageal, prevention of, endoscopy in, 231 250. See also Esophageal variceal bleeding, prevention of, endoscopy in. gastric, prevention of, 274 275 ß-Blockers, nonselective, in esophageal variceal bleeding prevention, 236 239 Brachytherapy, intraductal, in CCAs management, 341 342 Clin Liver Dis 14 (2010) 373 380 doi:10.1016/s1089-3261(10)00026-7 1089-3261/10/$ see front matter ª 2010 Elsevier Inc. All rights reserved. liver.theclinics.com
374 Index C Capsule endoscopy esophageal, in PHG detection, 213 215 in gastroesophageal varices diagnosis, 197 199 in portal hypertension, 209 220 esophageal capsule endoscopy in varices and PHG detection, 213 215 reasons for, 209 211 techniques, 211 213 small bowel, in PHG detection, 216 217 Cholangiocarcinoma(s) (CCAs) described, 333 diagnosis of described, 334 336 digital image analysis in, 336 ERCP in, 333 348 fluorescence in situ hybridization in, 336 337 intraductal ultrasound in, 337 per-oral cholangioscopy in, 337 338 management of ERCP in, 333 348 stents in, 338 340 high-intensity intraductal ultrasound in, 342 intraductal brachytherapy in, 341 342 photodynamic therapy in, 340 341 of large bile duct, vs. dominant stenoses, 354 355 risk factors for, 333 334 Cholangioscopy, per-oral, in CCAs diagnosis, 337 338 Chronic liver disease endoscopic sedation of patients with, 185 194 continuum of sedation, 189 discharge, 191 general principles, 189 191 hepatic encephalopathy and, 188 189 monitoring, 190 191 preprocedure assessment, 189 190 recovery, 191 special considerations, 191 192 unsedated endoscopy in, 191 192 Cirrhosis esophageal varices formation and bleeding in, 232 portal hypertension due to, 231 Computed tomography (CT), in gastroesophageal varices diagnosis, 201 CT. See Computed tomography (CT). D Digital image analysis, in CCAs diagnosis, 336 Dominant stenoses biliary infection and, 354 colonization and, 354 diagnosis of, ERCP in, 349 350
Index 375 incidence of, 350 management of antibiotics in, 354 balloon dilatation in, 352 353 endoscopic after disease recurrence, 355 reasons for, 352 vs. surgical, 351 352 liver transplantation in, after disease recurrence, 355 medical therapy in, 355 stenting in, 352 353 prevalence of, 350 vs. CCAs of large bile duct, 354 355 E EGD. See Esophagogastroduodenoscopy (EGD). EIS. See Endoscopic injection sclerotherapy (EIS). Encephalopathy(ies), hepatic, endoscopic sedation of patients with, 188 189 Endoscopic band ligation, in acute variceal bleeding management, 256 257 Endoscopic clipping, in esophageal varices prevention, 312 313 Endoscopic injection sclerotherapy (EIS) EVL with metachronous combination, 314 synchronous combination, 313 314 in esophageal varices prevention, 308 309 medical therapy with, 314 315 vs. EVL, 310 311 medical therapy vs., in esophageal varices prevention, 310 Endoscopic retrograde cholangiopancreatography (ERCP) in CCAs diagnosis and management, 333 348 in dominant stenoses diagnosis, 349 350 in PSC diagnosis and management, 349 358. See also Stenosis(es), dominant. Endoscopic sclerotherapy, in acute variceal bleeding management, 255 256 Endoscopic ultrasonography (EUS) in HCC diagnosis, 327 331 in measurement of wall tension of esophageal varices, 226 in portal hypertension evaluation, 221 229 cyanocrylate injection in perforating gastric veins, 227 esophageal collateral vessels sclerosis, 226 for risk factors for variceal bleeding, variceal recurrence, and post-treatment rebleeding, 225 226 gastric mucosal changes assessment, 225 hemodynamic abnormalities assessment, 225 portal vein catheterization, 227 Endoscopic variceal ligation (EVL) EIS with metachronous combination, 314 synchronous combination, 313 314 in esophageal varices prevention, 310
376 Index Endoscopic (continued) medical therapy with, 315 316 vs. EIS, 310 311 vs. medical therapy, 311 312 Endoscopy capsule in gastroesophageal varices diagnosis, 197 199 in portal hypertension, 209 220. See also Capsule endoscopy, in portal hypertension. in acute variceal bleeding management, 251 262 endoscopic band ligation, 256 257 endoscopic sclerotherapy, 255 256 in biliary complications management after liver transplantation, 359 371. See also Liver transplantation, biliary complications after. in esophageal variceal bleeding prevention, 231 250. See also Esophageal variceal bleeding, prevention of, endoscopy in. in esophageal varices prevention, 307 323. See also Esophageal varices, prevention of, endoscopy in. in gastric varices management, 263 279. See also Gastric varice(s), management of, endoscopic therapy in. in sedation of patients with chronic liver disease, 185 194. See also Chronic liver disease, endoscopic sedation of patients with. unsedated, in chronic liver disease, 191 192 Endosonography, in gastroesophageal varices diagnosis, 199 200 ERCP. See Endoscopic retrograde cholangiopancreatography (ERCP). Esophageal collateral vessels sclerosis, EUS-guided therapeutic interventions for, 226 Esophageal varice(s), 202 203 endoscopic classification and grading of, 232 234 in cirrhosis, formation and bleeding from, 232 management of, treatment failure, rescue therapy for, 316 317 prevention of endoscopy in, 307 323 EIS, 308 309 vs. medical therapy, 310 endoscopic clipping, 312 313 EVL, 310 vs. medical therapy, 311 312 histoacryl injection in, 313 risk stratification of, 234 wall tension of, EUS measurement of, 226 Esophageal variceal bleeding portal hypertension and, 307 prevention of endoscopy in, 231 250 clinical scenario for, 240 244 described, 232, 239 240 screening procedure, 234 236 target population identification, 234 236 therapies in, 236 239 Esophagogastroduodenoscopy (EGD), in gastroesophageal varices diagnosis, 197 Esophagus, balloon tamponade of, in acute variceal bleeding management, 257 258
Index 377 EUS. See Endoscopic ultrasonography (EUS). EVL. See Endoscopic variceal ligation (EVL). F Fine-needle aspiration (FNA), in HCC diagnosis, 327 331 Flumazenil, metabolism of, hepatic dysfunction and, 186 187 Fluorescence in situ hybridization, in CCAs diagnosis, 336 337 FNA. See Fine-needle aspiration (FNA). G Gastric varice(s), 203 204 classification of, 263 management of endoscopic therapy in, 263 279 combined therapies, 273 274 described, 263 264 gastric variceal band ligation, 269 270 gastric variceal obturation, 265 269 gastric variceal sclerotherapy, 264 265 thrombin in, 270 273 Gastric variceal band ligation, 269 270 Gastric variceal bleeding, prevention of, 274 275 Gastric variceal obturation, 265 269 Gastric variceal sclerotherapy, 264 265 Gastric vascular ectasia clinical presentation of, 288 described, 287 diagnosis of, 288 management of, 288 290 pathophysiology of, 288 Gastric veins, perforation of, cyanocrylate injection in, EUS-guided, 227 Gastroesophageal varices, 195 208 anatomy of, 195 196 diagnosis of, 196 202 capsule endoscopy in, 197 199 CT in, 201 EGD in, 197 endosonography in, 199 200 MRI in, 201 202 ultrasonography in, 200 201 grading of, 202 204 pathophysiology of, 195 196 Gastrointestinal wall, vascular abnormalities outside, portal hypertension and, 224 Gastropathy, portal hypertensive, esophageal capsule endoscopy for, 213 215 H HCC. See Hepatocellular carcinoma (HCC). Hemorrhage. See Bleeding.
378 Index Hepatic dysfunction, effects on metabolism of sedation drugs, 185 188 Hepatic encephalopathy, endoscopic sedation of patients with, 188 189 Hepatocellular carcinoma (HCC) described, 325 326 diagnosis of, 325 332 EUS in, 327 331 FNA in, 327 331 prevalence of, 325 surveillance of, 326 327 High-intensity intraductal ultrasound, in CCAs management, 342 Histoacryl injection, in esophageal varices prevention, 313 Hypertension, portal. See Portal hypertension. I Intraductal brachytherapy, in CCAs management, 341 342 Intraductal ultrasound high-intensity, in CCAs management, 342 in CCAs diagnosis, 337 Intramural vascular changes, in portal hypertension, recognition of, 221 223 L Liver, dysfunction of, effects on metabolism of sedation drugs, 185 188 Liver disease, chronic, endoscopic sedation of patients with, 185 194. See also Chronic liver disease, endoscopic sedation of patients with. Liver transplantation biliary complications after biliary casts, 367 biliary leaks, 365 367 biliary sludge, 367 diagnostic approach to, 361 362 endoscopic management of, 359 371 risk factors for, 359 361 sphincter of Oddi dysfunction, 368 in dominant stenoses management, 355 living-donor, as risk factor for biliary complications, 360 361 M Magnetic resonance imaging (MRI), in gastroesophageal varices diagnosis, 201 202 MRI. See Magnetic resonance imaging (MRI). N Naloxone, metabolism of, hepatic dysfunction and, 187 O Opioid(s), metabolism of, hepatic dysfunction and, 187
Index 379 P Per-oral cholangioscopy, in CCAs diagnosis, 337 338 PHG. See Portal hypertensive gastropathy (PHG). Photodynamic therapy, in CCAs management, 340 341 Portal hypertension capsule endoscopy in, 209 220. See also Capsule endoscopy, in portal hypertension. cirrhosis and, 231 described, 209 esophageal variceal hemorrhage due to, 307 evaluation of, EUS in, 221 229. See also Endoscopic ultrasonography (EUS), in portal hypertension evaluation. gastric vascular ectasia in. See Gastric vascular ectasia, in portal hypertension. gastropathy in. See Portal hypertensive gastropathy (PHG). intramural vascular changes in, recognition of, 221 223 vascular abnormalities outside gastrointestinal wall in, recognition of, 224 Portal hypertensive gastropathy (PHG) clinical picture of, 284 described, 281 282 detection of esophageal capsule endoscopy in, 213 215 small bowel capsule endoscopy in, 216 217 diagnosis of, 283 284 epidemiology of, 282 283 management of, 284 287 acute hemorrhage related, 286 287 chronic hemorrhage related, 285 286 natural history of, 284 pathophysiology of, 283 Portal vein catheterization, EUS-guided, 227 Primary sclerosing cholangitis (PSC) diagnosis and management of, ERCP in. See also Dominant stenoses. diagnosis of, ERCP in, 349 358 Propofol in chronic liver disease sedation, nonanesthesiologist administration of, 192 metabolism of, hepatic dysfunction and, 187 188 PSC. See Primary sclerosing cholangitis (PSC). R Refractory acute variceal bleeding, 297 305. See also Acute variceal bleeding, refractory. S Sclerosis(es), esophageal collateral vessels, EUS-guided therapeutic interventions for, 226 Sclerotherapy endoscopic, in acute variceal bleeding management, 255 256 endoscopic injection. See Endoscopic injection sclerotherapy (EIS). gastric variceal, 264 265 Sedation drugs, metabolism of, hepatic dysfunction effects on, 185 188 Small bowel capsule endoscopy, in PHG detection, 216 217
380 Index Sphincter of Oddi dysfunction, after liver transplantation, 368 Stenosis(es), dominant. See Dominant stenoses. Stent(s) endoscopic palliation with, in CCAs management, 338 340 in dominant stenoses management, 352 353 T Thrombin, in gastric variceal management, 270 273 TIPS. See Transjugular intrahepatic portosystemic shunt (TIPS). Transjugular intrahepatic portosystemic shunt (TIPS), in refractory acute variceal bleeding management, 299 302 Transplantation, liver. See Liver transplantation. U Ultrasonography endoscopic. See Endoscopic ultrasonography (EUS). in gastroesophageal varices diagnosis, 200 201 intraductal high-intensity, in CCAs management, 342 in CCAs diagnosis, 337 V Varice(s). See also specific types. detection of, esophageal capsule endoscopy in, 213 215 esophageal. See Esophageal varice(s). gastric. See Gastric varice(s). gastroesophageal, 195 208. See also Gastroesophageal varices. recurrence of, after portal hypertension management, risk factors for, EUS in assessment of, 225 226 Variceal bleeding acute management of, 251 262. See also Acute variceal bleeding, management of. refractory. See also Acute variceal bleeding, refractory. after portal hypertension management, risk factors for, EUS in assessment of, 225 226 described, 297 298 diagnosis of, 252 253 endoscopic sedation of patients with, 192 esophageal, prevention of, endoscopy in, 231 250. See also Esophageal variceal bleeding, prevention of, endoscopy in. gastric, prevention of, 274 275 natural history of, 252 253 Vasoconstrictor(s), in acute variceal bleeding management, 254 255