Methods: Prospective analysis of a cohort of consecutive 200 patients (94M: 106F, mean age 53 years) with chronic liver disease undergoing elective endoscopic screening procedures over 6 months, by a single endoscopist, in a liver transplant center. Of them, 187 (93%) had cirrhosis. One hundred thirty-five (67%) underwent EGD, and 52 (26%) had colonosco-pies BGJ398 molecular weight and 13 had both. Esophageal varices were detected in 117 (79%; small varices 16, medium varices 77, and large 24), and prophylactic esophageal variceal banding in multiple sessions was done in 78 (53%) patients. Biopsies with

EGD were done in 99 (67%) patients. On colonoscopy of 65 patients, 24 (36%) had polyps. Forty-five (70%) had biopsies taken, and polypectomies were done in 22 (34%); snare pol-ypectomy with cauterization for larger polyps (>1 cm) was done in 12 (18%). The mean platelet count was 112 k/cmm (range 20-180), mean INR 1.3 (1-2.9), and mean MELD 9.8 (6-31). The sedation was administered with

propofol, with or without midazolam. Following the procedure, patients were followed for worsening of encephalopathy, bleeding, SBP, or aspiration over 72 hours. Results: None of the patients had complications with worsening of encephalopathy, bleeding, SBP, or aspiration within 72 hours. None required PRBC, platelet, or FFP transfusion. Only one patient was Apoptosis inhibitor admitted with a variceal bleeding, after 5 days from post-banding ulceration, and recovered. Conclusion: Upper gastrointestinal endosco-pies and colonoscopies with interventions done electively in patients with end-stage liver disease are safe. The patients tolerate sedation with propofol well. A study with a large sample size is needed to establish medchemexpress the safety

of therapeutic endoscopy in patients with decompensated liver disease. Disclosures: The following people have nothing to disclose: Prasun K. Jalal “
“Upper gastrointestinal endoscopy, often referred to as EGD (esophago-gastro-duodenoscopy), is a common investigation that allows the physician to directly examine the esophagus, stomach, and duodenum. EGD also allows mucosal biopsies to be obtained as well as various therapeutic interventions to be performed. The endoscopy system had evolved from the fiberoptic technology in the 1960s to the state-of-art high-resolution and high-definition systems of today. Currently, endoscopes with integrated zoom lenses and microscopes are available and with these technologies, intestinal tissues can be imaged at cellular and nuclear levels which provide invivo optical histology. Image enhancement by altering the spectrum of visible light has allowed the delineation and characterization of subtle and early abnormalities of the gastrointestinal tract. This chapter will provide an overview of the endoscopic techniques and recent developments in this field.