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This prospective observational study evaluates whether endohepatology changes treatment indications in adults at high risk of metabolic dysfunction-associated steatotic liver disease. Non-invasive testing is followed, when indicated, by a single-session endohepatology assessment including EUS-guided shear-wave elastography, portal pressure gradient measurement and liver biopsy. The primary outcome is treatment reclassification compared with the prospectively documented non-invasive assessment.
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