The use of endoscopy in liver diseases.

The use of fibre-optic endoscopy has greatly facilitated the management of some patients with chronic liver disease. Upper endoscopy plays a pivotal role in the diagnosis and management of oesophageal and gastric varices. With the use of reflectance septrophotometry, gastroduodenal mucosal haemoglobin concentration and oxygen saturation can be more precisely measured. Recently, it has been shown that acute gastroduodenitis is associated with a lower pre-treatment mucosal oxygen concentration in the antrum and the first part of the duodenum. Endoscopic ultrasound is increasingly being used to detect varices and in the staging of gastrointestinal tumours. Endoscopic retrograde cholangiopancreatography plays an important role in the diagnosis of recurrent pyogenic cholangitis and endoscopic sphincterotomy is a useful form of treatment. Laparoscopy, with the aid of ultrasound and biopsy is helpful in staging chronic liver disease, identifying focal lesions, and diagnosing peritoneal disease.