Precise diagnosis and treatment of liver diseases with endohepatology at Vivomed - Gastroenterology Bern
Endohepatology is a highly specialized field of gastroenterology that uses state-of-the-art endoscopic and ultrasound-based procedures to examine diseases of the liver, portal vein and bile ducts with particular precision.
At Vivomed - Gastroenterology Bern, we offer a comprehensive range of endohepatological examinations that are only available in this combination at a few centers in Switzerland. Many people from all over German-speaking Switzerland come to us to benefit from this precise diagnostic service.
Our goal is clear: early detection, reliable diagnosis and optimal treatment of your liver disease - gentle, targeted and at the cutting edge of medicine.
What is endohepatology?
Endohepatology combines the methods of endoscopy with the latest ultrasound technology inside the body. This produces particularly high-resolution images of the liver, portal vein, bile ducts and adjacent structures - far more accurate than ultrasound through the abdominal wall.
This proximity to the organs enables diagnoses that would otherwise be difficult or impossible. It is particularly helpful for
- unclear liver changes,
- Suspected liver tumors or bile duct tumors,
- Liver cirrhosis and portal hypertension,
- Portal vein thrombosis,
- unclear bile duct dilatation,
- diffuse or chronic liver diseases,
- Complaints in the right upper abdomen for which other examinations do not provide a sufficiently clear explanation.
Our endohepatology services at a glance
Vivomed offers five highly specialized procedures that complement each other and enable a particularly accurate diagnosis. Below we explain these methods in a clear and patient-oriented way.
1. Endosonographic liver ultrasound
High-resolution imaging of the liver - closer and more precise than any other ultrasound
In endosonographic liver ultrasound (EUS), an ultrasound probe is guided into the stomach or duodenum via an endoscope. From there, we can examine the liver with a level of detail that ultrasound cannot achieve from the outside.
This technique is particularly valuable for
- Assessment of small liver foci,
- close examination of the hepatic hilus,
- Visualization of the portal vein and its branches,
- Clarification of unclear findings from CT or MRI,
- Assessment of the bile ducts if there is a suspicion of constriction or inflammation.
For our patients, this means earlier and more reliable diagnoses with minimal stress.
2. Endosonographic liver palpation (EUS-LP)
The "digital palpation" from the inside
EUS liver palpation is an innovative procedure that allows us to palpate the liver acoustically. The ultrasound device measures how firm or soft the tissue is - similar to a doctor palpating from the outside, but from the inside and therefore much more accurately.
This method helps with
- Assessing fibrosis,
- Distinguishing between inflammatory and structural changes,
- initial indications of possible early stages of liver cirrhosis.
EUS-LP is completely painless for you and is carried out as part of endosonography.
3. Endosonographic liver biopsy (EUS-LB)
Precise tissue sampling - safe and minimally invasive
The EUS-guided liver biopsy allows us to take a tissue sample from the liver under direct vision and with a high degree of safety.
In contrast to classic liver biopsy through the skin, EUS-LB:
- better targeting accuracy,
- a lower risk of bleeding
- higher diagnostic yield due to precise placement of the needle,
- often more comfort, as it is performed under sedation.
This method is irreplaceable, particularly in the case of difficult-to-access or small changes.
4. Endosonographic shear wave elastography (EUS-SWE)
Measurement of "liver hardness" to assess fibrosis and cirrhosis
EUS shear wave elastography measures the elasticity of the liver - i.e. how firm or soft the tissue is. Increased firmness often indicates fibrosis or incipient cirrhosis.
EUS-SWE is performed directly from close up inside the body and is particularly reliable when
- external factors (e.g. obesity, ribcage, intestinal gas) make elastography through the abdominal wall difficult,
- the question of the exact stage of fibrosis is decisive for the therapy,
- a precise follow-up is required.
This will give you a more accurate assessment of your liver condition - and we can plan your treatment optimally.
5. Endosonographic portal pressure measurement (EUS-PPM)
The most modern method for assessing portal hypertension
Portal pressure measurement is a revolutionary procedure that only a few centers offer. With EUS-PPM, the pressure in the portal vein is measured directly and precisely - without major interventions.
This is particularly important for patients with:
- Liver cirrhosis,
- Suspected portal hypertension, varices in the oesophagus or stomach,
- unclear edema or ascites,
- increased risk of bleeding.
The examination enables early diagnosis, assessment of the risk of disease and targeted treatment planning.
Who is endohepatology suitable for?
Our examinations are particularly helpful for people with
- unexplained liver complaints or abnormal laboratory values,
- Changes in CT/MRI or ultrasound,
- chronic liver diseases,
- Liver cirrhosis or suspected fibrosis,
- Problems with the bile ducts,
- portal hypertension or suspected varices.
Whether you come from Bern, Zurich, Basel, Lucerne, St. Gallen or Valais - we specialize in complex cases and offer diagnostics at university hospital level without airs and graces.
Vivomed - your center for endohepatology in German-speaking Switzerland
Precise diagnostics. Modern technology. Human care.
Endohepatology is one of the most modern areas of gastroenterology. At Vivomed - Gastroenterology Bern you benefit from:
- many years of expertise,
- state-of-the-art endoscopy equipment,
- gentle examination methods,
- excellent image quality,
- individual, patient-centered care.
We take our time for you - and accompany you from the initial consultation through diagnostics to the treatment decision.