Endoscopic management of choledocholithiasis and cholelithiasis in patients with cirrhosis

Ali S. Khan, Mohamad A. Eloubeidi, Mouen A. Khashab

Research output: Contribution to journalReview articlepeer-review

Abstract

Treatment of choledocholithiasis and cholelithiasis in patients with cirrhosis often requires diagnostic and therapeutic endoscopy such as endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP). Patients with underlying cirrhosis may have coagulopathy, hepatic encephalopathy, ascites and other comorbidities associated with cirrhosis that can make endoscopic therapy challenging and can be associated with a higher risk of adverse events. Given the unique derangements of physiologic parameters associated with cirrhosis this population requires a truly multifaceted and multidisciplinary understanding between therapeutic endoscopists, hepatologists and anesthesiologists. For therapeutic endoscopists, it is critical to be aware of the specific issues unique to this population of patients to optimize outcomes and avoid adverse events. The epidemiology of gallstone disease, the diagnostic and therapeutic approach to patients with varying degree of hepatic dysfunction, and a review of the available literature in this area are presented.

Original languageEnglish (US)
Pages (from-to)861-868
Number of pages8
JournalExpert Review of Gastroenterology and Hepatology
Volume10
Issue number7
DOIs
StatePublished - Jul 2 2016

Keywords

  • Ascites
  • Choledocholithiasis
  • Cholelithiasis
  • EUS
  • MRCP

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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