000			04143nam a22001817a 4500
008			210623b |||||||| |||| 00| 0 eng d
020			_a978-3-319-72627-4
020			_a978-3-319-72628-1
100			_aAnnalisa Berzigotti _915953
245			_aDiagnostic Methods for Cirrhosis and Portal Hypertension
260			_aUniversity of Bern Berne Switzerland _b Springer International Publishing AG, part of Springer Nature _c2018
300			_a337 Pages
500			_aIncludes References
520			_aThe past years have witnessed an enormous advancement in all areas of hepatology, from molecular pathophysiology to diagnostic techniques and therapy, to the point that we have now effective therapies for most liver diseases and noninvasive diagnostic tests are creating new gold standards for diagnosis that before required difficult and demanding invasive techniques. These changes are paramount most especially in the diagnosis of cirrhosis and portal hypertension. We come from an era when cirrhosis was diagnosed based on liver biopsy to one when pathologists prefer to use the term “advanced chronic liver disease” instead of “cirrhosis,” thus underlining the dynamic nature of disease process. In this scenario, different disease stages are better defined on the basis of clinical, imaging, and hemodynamic characteristics than by the biopsy findings that correlate poorly with patient outcome. This is well illustrated by the fact that with similar liver biopsy findings, patient prognosis can be very good (as exemplified by the compensated patient without portal hypertension) or extremely poor (as in the case of the decompensated patient with multiple complications). The above considerations emphasize one of the major requirements in modern medicine, that is, diagnostic tests should be able to inform on prognosis, therefore providing the basis for both risk stratification at the time of diagnosis and personalizing treatment. This approach has been used to devise this book that reviews the more recent advances in the diagnostic methods for cirrhosis, the main complication of portal hypertension, and non-cirrhotic causes of portal hypertension. We are making special emphasis on new noninvasive methods and on the use of these tests in the different stages of cirrhosis and different complications of portal hypertension. After being part of the standard of care for the adult population, noninvasive diagnostic methods are increasingly used in the pediatric population with cirrhosis and/or portal hypertension, and this aspect as well as the specificities of diagnostics in Western and Eastern countries is taken into account. Our aim is to offer to the general hepatologists and hepatologists in training the current state of the art regarding the many different techniques available and under development for clinical decision making. We hope the reader will find in the different chapters of this book—all written by well-known opinion leaders in their fields—a concise but comprehensive and updated, clinically focused guide to answer difficult questions, such as when to think about rare causes of non-cirrhotic _bportal hypertension (e.g., long-lasting porto-sinusoidal disease), when to start endoscopic surveillance in a given patient, or when to shift from a completely noninvasive assessment to an invasive measurement of HVPG in different clinical scenarios (e.g., sustained virological response after treatment with direct-acting antivirals). We would like to acknowledge the commitment and efforts of all the authors from different disciplines (hepatology, endoscopy, radiology, pathology) and from the different areas of the world that have contributed to this book. They provide an outstanding example of what interdisciplinary collaboration can bring into the complex field of hepatology. We hope that this book will be helpful for hepatologists and physicians interested in liver diseases in order to select the most appropriate diagnostic methods for their patients with cirrhosis and/or portal hypertension.
654			_xHepatology
700			_aJaime Bosch _915954
942			_2ddc _cEB
999			_c832 _d832