TAILIEUCHUNG - Ebook Endoscopy in liver disease: Part 2

Part 2 book “Endoscopy in liver disease” has contents: Colonoscopic screening and surveillance in the patient with liver disease, endoscopic retrograde cholangiopancreatography and cholangioscopy in hepatobiliary disease, endoscopic ultrasound in the diagnosis of hepatobiliary malignancy, endoscopic ultr asound guided biliary drainage, endoscopic c onfocal and molecular imaging in hepatobiliary disease, and other contents. | 173 11 Colonoscopic Screening and Surveillance in the Patient with Liver Disease (Including Post‐Transplant) William M. Tierney1 and Khadija Chaudrey2 1 Professor of Medicine, Digestive Diseases and Nutrition Section, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA 2 Gastroenterologist, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA Introduction Patients with liver disease and expected long term survival warrant standard health maintenance screening to promote health. On the other hand, patients with advanced cirrhosis who are not candi­ dates for transplantation may have limited survival and may thus not be suitable for routine health screening. This may be especially true for screening with finite risks. Finally, in liver patients who are candidates for transplantation, health screens serve not only to preserve health but also to select patients without serious extrahepatic disease that would limit life expectancy or complicate the post‐trans­ plant course. Colonoscopy for colorectal cancer (CRC) screening or surveillance for adenomatous polyps falls into this category of health screens that warrants selective and thoughtful application in patients with liver disease. Some liver diseases, such as primary sclerosing chol­ angitis (PSC) with associated colitis, are known risk factors for CRC and deserve special consideration [1,2]. This chapter outlines and discusses the colonoscopic screening and surveillance guidelines that apply to patients with liver disease, including post‐transplant patients. Screening Colonoscopy in Average Risk Populations Colorectal cancer is the third most com­ mon cancer in the USA and the second leading cause of cancer death [3]. CRC screening and surveillance are effective and have consistently been shown to reduce CRC related morbidity and mor­ tality. Prevention and early detection of CRC in screening populations have led to decreased incidence and death rates. In