Advanced cystic fibrosis liver disease: Endovascular, endoscopic, radiologic, and surgical considerations

Pediatr Pulmonol. 2024 Sep:59 Suppl 1:S115-S122. doi: 10.1002/ppul.27174.

Abstract

Up to 90% of people with CF (pwCF) will have some form of hepatobiliary involvement. This manuscript aims to explore the different endovascular, endoscopic, radiological and surgical procedures available to diagnose and manage the most severe form of CF hepatobiliary involvement (CFHBI) known as advanced cystic fibrosis liver disease (aCFLD), seen in 10% of pwCF. These procedures and interventions include liver biopsy, hepatic venous pressure gradient measurement, gastrostomy tube placement to optimize nutrition, paracentesis, endoscopic variceal control of bleeding and portosystemic shunting before liver transplantation. By utilizing advanced diagnostic or surgical techniques, healthcare professionals of pwCF can more effectively manage patients with CFHBI and aCFLD and potentially improve patient outcomes.

Keywords: cystic fibrosis (CF).

Publication types

  • Review

MeSH terms

  • Cystic Fibrosis* / complications
  • Cystic Fibrosis* / diagnostic imaging
  • Cystic Fibrosis* / surgery
  • Endovascular Procedures / methods
  • Gastrostomy / methods
  • Humans
  • Liver Diseases / diagnostic imaging
  • Liver Diseases / surgery
  • Liver Transplantation
  • Paracentesis / methods
  • Portasystemic Shunt, Surgical / methods

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