Dr. Ran Wang is the attending physician of the Department of Gastroenterology, General Hospital of Northern Theater Command, China. His major research interests include the etiology, diagnosis, and management of liver cirrhosis, portal hypertension, and portal vein thrombosis. He is a committee member of the Liaoning Immunology Society, Liver and Immunology Subdivision.
Liver cirrhosis, the final stage of various chronic liver diseases, poses significant health challenges and carries a severe prognosis. This book provides a comprehensive review of the advancements in the diagnosis and management of liver cirrhosis and its complications. Spanning six chapters, this book delves into critical areas including diagnostic approaches and therapeutic strategies for cirrhosis, transarterial radioembolization (TARE) for hepatocellular carcinoma, the pathology of hepatic encephalopathy, and clinical applications of non-selective beta blockers (NSBBs) in cirrhosis management. Bringing together clinical and pathological perspectives, this book features contributions from esteemed authors worldwide. This multidisciplinary approach ensures a thorough understanding of the progress in diagnosing and managing cirrhosis and its complications. This book is designed to offer healthcare professionals, researchers, and students fresh insights and innovative approaches, aiming to enhance diagnostic and therapeutic practices for liver cirrhosis.
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Gastroesophageal varices are the most common complication of portal hypertension and associated with a worse prognosis. Endoscopy is the gold standard method to diagnose gastroesophageal varices. However, endoscopy is an invasive method with potential complications and is not well adhered by patients. Non-invasive methods, including serum markers or scores, computed tomography, ultrasonographic, and elastography-based methods, have been explored for the diagnosis of gastroesophageal varices. In the current chapter, we will briefly review non-invasive methods for the prediction of gastroesophageal varices.
Part of the book: Portal Hypertension
Part of the book: Liver Cirrhosis and Its Complications
Non-selective beta-blockers (NSBBs) are the cornerstone of management of liver cirrhosis and its complications. They decrease portal vein blood flow and portal vein pressure via antagonism of β1 and β2 receptors, thereby improving the hyperdynamic circulatory status and reducing the risk of decompensated events in cirrhotic patients with portal hypertension (PH). Currently, NSBBs have been recommended for the primary and secondary prevention of variceal bleeding in patients with cirrhosis. Nevertheless, it has been noted that the clinical risk-benefit ratio appears to deteriorate for NSBBs in patients with advanced liver cirrhosis. Considering that the use of NSBBs in the clinical practice of cirrhotic patients remains controversial, this chapter aims to summarize the evidence of current recommendations and controversies regarding the use of NSBBs in patients with cirrhosis.
Part of the book: Liver Cirrhosis and Its Complications