Endoscopy in Liver Disease Endoscopy in Liver Disease Edited by John N. Plevris Centre for Liver and Digestive Disorders Royal Infirmary of Edinburgh University of Edinburgh Edinburgh, Scotland, UK Peter C. Hayes Centre for Liver and Digestive Disorders Royal Infirmary of Edinburgh University of Edinburgh Edinburgh, Scotland, UK Patrick S. Kamath Division of Gastroenterology and Hepatology Mayo Clinic Rochester, Minnesota, USA Louis M. Wong Kee Song Division of Gastroenterology and Hepatology Mayo Clinic Rochester, Minnesota, USA This edition first published 2018 © 2018 by John Wiley & Sons Ltd. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions. The right of John N. Plevris, Peter C. 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Description: First edition. | Hoboken, NJ : Wiley, 2018. | Includes bibliographical references and index. | Identifiers: LCCN 2017026560 (print) | LCCN 2017027059 (ebook) | ISBN 9781118660850 (pdf) | ISBN 9781118660843 (epub) | ISBN 9781118660874 (cloth) Subjects: | MESH: Liver Diseases–diagnostic imaging | Endoscopy, Digestive System–methods Classification: LCC RC847.5.I42 (ebook) | LCC RC847.5.I42 (print) | NLM WI 700 | DDC 616.3/6207545–dc23 LC record available at https://lccn.loc.gov/2017026560 Cover image: Courtesy of Louis-Michel Wong Kee Song Cover design by Wiley Set in 10/12pt Warnock by SPi Global, Pondicherry, India 10 9 8 7 6 5 4 3 2 1 v Contents List of Contributors vii Preface xi About the Companion Website xii 1 Equipment, Patient Safety, and Training 1 John N. Plevris and Scott Inglis 2 Sedation and Analgesia in Endoscopy of the Patient with Liver Disease 19 Rohit Sinha, Anastasios Koulaouzidis, and John N. Plevris 3 Endoscopy in the Setting of Coagulation Abnormalities in the Patient with Liver Disease 29 Bezawit Tekola and Stephen Caldwell 4 Varices: Screening, Staging, and Primary Prophylaxis 43 Alan Bonder, Ignacio Alfaro, and Andres Cardenas 5 Endoscopic Management of Acute Variceal Bleeding 55 Marcus C. Robertson and Peter C. Hayes 6 Prevention of Recurrent Bleeding from Esophageal Varices 97 Annalisa Berzigotti, Fanny Turon, and Jaime Bosch 7 Refractory Variceal Bleeding: When First Endoscopy Fails, What Next? 111 Virginia Hernández‐Gea, Fanny Turon, and Juan Carlos García‐Pagán 8 Portal Hypertensive Gastropathy and Gastric Vascular Ectasia 119 Cristina Ripoll and Louis M. Wong Kee Song 9 Portal Hypertensive Enteropathy and Obscure Gastrointestinal Bleeding 143 Anastasios Koulaouzidis, Emanuele Rondonotti, and Roberto de Franchis 10 Endoscopic Management of Upper Gastrointestinal Pathology in the Patient with Liver Disease 155 Selina Lamont and Adrian Stanley vi Contents 11 Colonoscopic Screening and Surveillance in the Patient with Liver Disease (Including Post‐Transplant) 173 William M. Tierney and Khadija Chaudrey 12 Endoscopic Retrograde Cholangiopancreatography and Cholangioscopy in Hepatobiliary Disease 195 Klaus Mönkemüller, Giovani E. Schwingel, Alvaro Martinez‐Alcala, and Ivan Jovanovic 13 Endoscopic Ultrasound in the Diagnosis of Hepatobiliary Malignancy 229 Michael J. Levy , Larissa Fujii‐Lau, Julie K. Heimbach, and Gregory J. Gores 14 Endoscopic Ultrasound Guided Biliary Drainage 245 Mouen A. Khashab, Shyam Varadarajulu, and Robert H. Hawes 15 Hepatobiliary Endoscopy in the Patient with Liver Disease and Altered Anatomy 259 Stuart K. Amateau and Raj J. Shah 16 Management of Post‐Liver Transplant Hepatobiliary Complications 279 Ryan Law, Larissa Fujii‐Lau, and Todd H. Baron 17 Endoscopic Confocal and Molecular Imaging in Hepatobiliary Disease 295 Michael S. Hoetker and Martin Goetz 18 Laparoscopy in Patients with Hepatobiliary Disease 305 Tom K. Gallagher, Ewen M. Harrison, and O. James Garden Index 323 vii List of Contributors Ignacio Alfaro, MD Beth Israel Deaconess Medical Center Specialist Member Harvard Medical School Institute of Digestive Diseases and Boston, Massachusetts, USA Metabolism Hospital Clinic Jaime Bosch, MD, PhD, FRCP Barcelona, Spain Professor of Medicine and Senior Consultant Hepatologist Stuart K. Amateau, MD, PhD Hepatic Hemodynamic Laboratory and Assistant Professor of Medicine Liver Unit Director of Endoscopy Hospital Clinic Division of Gastroenterology and University of Barcelona Hepatology Barcelona, Spain; University of Minnesota Guest Professor of Hepatology Medical Center Inselspital, University of Bern Minneapolis, Minnesota, USA Bern, Switzerland Todd H. Baron, MD, FASGE Stephen Caldwell, MD, FAASLD Professor of Medicine Professor of Medicine Director of Advanced Therapeutic GI/Hepatology Endoscopy Digestive Health Center Division of Gastroenterology and University of Virginia Hepatology Charlottesville, Virginia, USA University of North Carolina Chapel Hill, North Carolina, USA Andres Cardenas, MD, MMSc, PhD, AGAF, FAASLD Annalisa Berzigotti, MD, PhD Faculty Member/Consultant Associate Professor of Medicine Institute of Digestive Diseases and (Hepatology) Metabolism University Clinic for Visceral Surgery Hospital Clinic and Medicine Barcelona, Spain Inselspital, University of Bern Bern, Switzerland Khadija Chaudrey, MD Gastroenterologist Alan Bonder, MD Division of Gastroenterology and Assistant Professor of Medicine Hepatology Division of Gastroenterology and Mayo Clinic Hepatology Rochester, Minnesota, USA viii List of Contributors Roberto de Franchis, MD Gregory J. Gores, MD Professor of Gastroenterology Professor of Medicine Department of Biomedical and Clinical Division of Gastroenterology and Sciences Hepatology University of Milan Mayo Clinic Milan, Italy Rochester, Minnesota, USA Ewen M. Harrison, PhD, FRCSEd Larissa Fujii‐Lau, MD Clinical Senior Lecturer and Honorary Assistant Professor of Medicine Consultant Surgeon Department of Gastroenterology Hepatobiliary and Pancreatic Surgical Queens Medical Center Services University of Hawaii Department of Clinical Surgery Honolulu, Hawaii, USA Royal Infirmary of Edinburgh Edinburgh, Scotland, UK Tom K. Gallagher, MCh, FRCSI Robert H. Hawes, MD Consultant Hepatobiliary and Transplant Surgeon Professor of Medicine St. Vincent’s University Hospital University of Central Florida College of Dublin, Ireland Medicine Medical Director Florida Hospital Institute for Minimally Juan Carlos García‐Pagán, MD, PhD Invasive Therapy Barcelona Hepatic Hemodynamic Florida Hospital Orlando Laboratory Orlando, Florida, USA Liver Unit, Hospital Clinic Barcelona Institut d’Investigacions Biomèdiques Peter C. Hayes, MD, PhD August Pi I Sunyer (IDIBAPS) Professor of Hepatology University of Barcelona Liver Unit and Centre for Liver and CIBERehd (Centro de Investigación Digestive Disorders en Red de Enfermedades Hepáticas y Royal Infirmary of Edinburgh Digestivas) University of Edinburgh Barcelona, Spain Edinburgh, Scotland, UK Julie K. Heimbach, MD O. James Garden, CBE, MD, FRCSEd Professor of Medicine Regius Professor of Clinical Department of Surgery Surgery and Honorary Consultant Mayo Clinic Surgeon Rochester, Minnesota, USA Hepatobiliary and Pancreatic Surgical Services Virginia Hernández‐Gea, MD, PhD Department of Clinical Surgery Barcelona Hepatic Hemodynamic Royal Infirmary of Edinburgh Laboratory Edinburgh, Scotland, UK Liver Unit, Hospital Clinic Barcelona Institut d’Investigacions Biomèdiques Martin Goetz, MD August Pi I Sunyer (IDIBAPS) Professor of Endoscopy University of Barcelona Innere Medizin 1 CIBERehd (Centro de Investigación en Red Universitätsklinikum Tübingen de Enfermedades Hepáticas y Digestivas) Tübingen, Germany Barcelona, Spain List of Contributors ix Michael S. Hoetker, MD Alvaro Martinez‐Alcala, MD Innere Medizin 1 Visiting Fellow Universitätsklinikum Tübingen Therapeutic Endoscopy Tübingen, Germany Basil I. Hirschowitz Endoscopic Center of Excellence Scott Inglis, BSc, MSc, PhD, MIPEM, CSci University of Alabama Senior Clinical Scientist and Honorary Birmingham, Alabama, USA Lecturer Medical Physics, NHS Lothian/ Klaus Mönkemüller, MD, PhD, FASGE University of Edinburgh Professor of Medicine Royal Infirmary of Edinburgh Helios Klinikum Jerichower Land Edinburgh, Scotland, UK Teaching Hospital of the Otto‐von‐Guericke University Ivan Jovanovic, MD, PhD Burg, Germany Professor of Medicine University of Belgrade John N. Plevris, MD, PhD, FRCPE, FEBGH Belgrade, Serbia Professor and Consultant in Gastroenterology Mouen A. Khashab, MD Centre for Liver and Digestive Disorders Associate Professor of Medicine Royal Infirmary of Edinburgh Department of Medicine and Division University of Edinburgh of Gastroenterology and Hepatology Edinburgh, Scotland, UK The Johns Hopkins Hospital Baltimore, Maryland, USA Cristina Ripoll, MD Assistant Professor Anastasios Koulaouzidis, MD, FEBG, First Department of Internal Medicine FACG, FASGE Martin‐Luther‐Universität Associate Specialist Halle‐Wittenberg Endoscopy Unit, Centre for Liver and Halle (Saale), Germany Digestive Disorders Royal Infirmary of Edinburgh Marcus C. Robertson, MBBS (Hons), Edinburgh, Scotland, UK BSci (Biotechnology) Liver Transplant and Hepatology Fellow Selina Lamont, MBChB, FRCPSGlasg Centre for Liver and Digestive Consultant Gastroenterologist Disorders Royal Alexandra Hospital Royal Infirmary of Edinburgh Paisley, Scotland, UK Edinburgh, Scotland, UK Ryan Law, DO Emanuele Rondonotti, MD, PhD Clinical Lecturer of Medicine Gastroenterology Unit Division of Gastroenterology Valduce Hospital University of Michigan Como, Italy Ann Arbor, Michigan, USA Giovani E. Schwingel, MD Michael J. Levy, MD Attending Physician, Consultant Professor of Medicine Cirurgia do Aparelho Digestivo Division of Gastroenterology and Gastroenterologia Hepatology, Mayo Clinic São Bento do Sul Rochester, Minnesota, USA Santa Catarina, Brazil x List of Contributors Raj J. Shah, MD, AGAF William M. Tierney, MD, FASGE, AGAF Professor of Medicine Professor of Medicine Division of Gastroenterology and Digestive Diseases and Nutrition Hepatology Section Director, Pancreaticobiliary Endoscopy University of Oklahoma University of Colorado Anschutz Health Sciences Center Medical Campus Oklahoma City, Oklahoma, USA Aurora, Colorado, USA Fanny Turon, MD Rohit Sinha, MBBS, MRCP(UK), Barcelona Hepatic Hemodynamic PgDip(Lon) Laboratory Liver Unit, Hospital Clinic Barcelona, Clinical Research Fellow in Hepatology CIBERehd (Centro de Investigación Centre for Liver and Digestive Disorders en Red de Enfermedades Hepáticas y Royal Infirmary of Edinburgh Digestivas), Barcelona, Spain University of Edinburgh Edinburgh, Scotland, UK Shyam Varadarajulu, MD Professor of Medicine Adrian Stanley, MBChB, MD, FRCPEd, University of Central Florida College FRCPSGlasg of Medicine Consultant Gastroenterologist and Medical Director Honorary Clinical Associate Professor Center for Interventional Endoscopy Glasgow Royal Infirmary Florida Hospital Orlando Glasgow, Scotland, UK Orlando, Florida, USA Bezawit Tekola, MD Louis M. Wong Kee Song, MD, FASGE Senior Fellow Professor of Medicine GI/Hepatology Division of Gastroenterology and Digestive Health Center Hepatology University of Virginia Mayo Clinic Charlottesville, Virginia, USA Rochester, Minnesota, USA xi Preface Endoscopy is an integral part of the diag- imaging, confocal probes, and dedicated nosis and therapy of several conditions stents for variceal tamponade, to mention related to liver disease. Over the past but a few. decade, there has been a dramatic improve- We, at the Mayo Clinic and at Royal ment in the technology and the number Infirmary of Edinburgh, envisioned the of endoscopic techniques available to the utility of putting together a collection of hepatologist or gastroenterologist with articles about the role of endoscopy in liver an interest in liver disease. This book disease, which would be of interest to those fulfills the need for a comprehensive cover working or training in this area. We have of all aspects of endoscopic procedures in been fortunate to enlist clinicians and the patient with liver disease including scientists with international recognition in post‐liver transplantation. These range the field to contribute highly informative from well established procedures, such and practically useful chapters to the book. as endoscopic band ligation of varices, to We acknowledge the support of Wiley for novel approaches, such as EUS guided bringing this endeavor to fruition. coil or glue injection of gastric varices and radiofrequency ablation of gastric John N. Plevris antral vascular ectasia. The apparatus we Peter C. Hayes use has improved continuously with the Patrick S. Kamath development of endoscopes for enhanced Louis M. Wong Kee Song