The Liver Meeting 2020-AASLD/ASGE Endoscopy Course Endoscopic Management of Hepatobiliary Disease: The Great 2020 Debates

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Video Summary

Endoscopic ultrasound-guided gallbladder drainage is a safe and effective alternative to percutaneous cholecystosomies for acute cholecystitis, particularly in high-risk patients. This technique involves stenting and offers benefits such as reduced rates of recurrent cholecystitis and shorter hospital stays. It is crucial to promote these endoscopic interventions as standard options for managing acute cholecystitis. The advanced techniques for bile duct strictures have their advantages but can sometimes lead to uncertainty due to the diversity of strictures and limitations of diagnostic methods. Improving tissue diagnosis techniques and refining multidisciplinary approaches are essential for better patient care.<br /><br />Artificial intelligence advancements in gastroenterology and hepatology have led to the development of machine learning models to identify and classify gastrointestinal and liver pathologies. These AI applications have shown promise in assisting with lesion detection during endoscopic procedures, especially capsule endoscopy. However, there is still room for improvement, notably in utilizing AI for liver assessments using endoscopic ultrasound. A recent study demonstrated the high accuracy of a CNN model in autonomously identifying and categorizing focal liver lesions as benign or malignant on EUS images, although further prospective validation is required.<br /><br />Future AI research in gastroenterology and hepatology aims to implement existing models, validate new methodologies, and explore applications in various conditions like varices, NASH, fibrosis prediction, and prognostication in liver disease. Collaboration between endoscopy and hepatology can further enhance patient care outcomes through AI technologies.

Keywords

Endoscopic ultrasound-guided gallbladder drainage

Percutaneous cholecystostomies

Acute cholecystitis

Stenting

Recurrent cholecystitis

Bile duct strictures

Diagnostic methods

Artificial intelligence advancements

Machine learning models

Gastroenterology

Hepatology

Lesion detection

Capsule endoscopy

Liver assessments

Focal liver lesions