Abstract:
Endoscopic ligation, sclerotherapy and injection of tissue glue combined with medicine treatment have replaced surgical shunt and devascularization as the first-line treatment recommended by guidelines for esophagogastric variceal bleeding in patients with cirrhosis and portal hypertension. However, some of the variceal bleeding induced by non-cirrhotic portal hypertension. Comorbidities such as diabetes, portal vein thrombosis, liver tumors, and hepatic artery-portal vein fistulas have reduced the efficacy of endoscopic treatment, and have increased the rate of complication such as ectopic embolism. Traditional endoscopic techniques are facing substantial challenges. The urgent needs for precise injection techniques, complete variceal obliteration, and the prevention of ectopic embolism have become apparent. The era of precision medicine in variceal endoscopic treatment has been ushered in by advancements such as preoperative assessments using computed tomography (CT) and ultrasound endoscopy, ultrasound-guided tissue glue injection with spring coil assistance, and immediate postoperative ultrasound endoscopic evaluation. This progress is anticipated to overcome the diagnostic and therapeutic limitations associated with non-cirrhotic portal hypertension. Integrating CT imaging virtual simulation and other technological innovations, to surpass conventional interventional techniques, is helpful of achieving a comprehensive endoscopic approach to the diagnosis and treatment of portal hypertension.