Chinese guidelines on management of hepatic encephalopathy in cirrhosis

doi:10.3748/wjg.v25.i36.5403

Practice Guideline

. 2019 Sep 28;25(36):5403-5422.

doi: 10.3748/wjg.v25.i36.5403.

Chinese guidelines on management of hepatic encephalopathy in cirrhosis

Affiliations

¹ Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China. xiaoyuanxu6@163.com.
² Hepatology and Digestion Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
³ Department of Liver Oncology, Cancer Radiation Therapy Center, Fifth Medical Center, PLA General Hospital, Beijing 100039, China.
⁴ Hepatology Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
⁵ Hepatobiliary and Pancreatic Department, Beijing Tsinghua Changgeng Hospital, Beijing 102218, China.
⁶ Artificial Liver Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
⁷ Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
⁸ Department of Gastroenterology, First Medical Center, PLA General Hospital, Beijing 100853, China.
⁹ Department of Pathogenic Biology, Peking University Health Science Center, Beijing 100191, China.

PMID: 31576089
PMCID: PMC6767982
DOI: 10.3748/wjg.v25.i36.5403

Practice Guideline

Chinese guidelines on management of hepatic encephalopathy in cirrhosis

Xiao-Yuan Xu et al. World J Gastroenterol. 2019.

. 2019 Sep 28;25(36):5403-5422.

doi: 10.3748/wjg.v25.i36.5403.

Authors

Affiliations

¹ Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China. xiaoyuanxu6@163.com.
² Hepatology and Digestion Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
³ Department of Liver Oncology, Cancer Radiation Therapy Center, Fifth Medical Center, PLA General Hospital, Beijing 100039, China.
⁴ Hepatology Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
⁵ Hepatobiliary and Pancreatic Department, Beijing Tsinghua Changgeng Hospital, Beijing 102218, China.
⁶ Artificial Liver Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China.
⁷ Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
⁸ Department of Gastroenterology, First Medical Center, PLA General Hospital, Beijing 100853, China.
⁹ Department of Pathogenic Biology, Peking University Health Science Center, Beijing 100191, China.

PMID: 31576089
PMCID: PMC6767982
DOI: 10.3748/wjg.v25.i36.5403

Abstract

The Chinese Society of Hepatology developed the current guidelines on the management of hepatic encephalopathy in cirrhosis based on the published evidence and the panelists' consensus. The guidelines provided recommendations for the diagnosis and management of hepatic encephalopathy (HE) including minimal hepatic encephalopathy (MHE) and overt hepatic encephalopathy, emphasizing the importance on screening MHE in patients with end-stage liver diseases. The guidelines emphasized that early identification and timely treatment are the key to improve the prognosis of HE. The principles of treatment include prompt removal of the cause, recovery of acute neuropsychiatric abnormalities to baseline status, primary prevention, and secondary prevention as soon as possible.

Keywords: Diagnosis; Hepatic encephalopathy; Liver cirrhosis; Therapy.

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Conflict of interest statement

Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.

Figures

**Figure 1**
Clinical diagnosis and treatment process of hepatic encephalopathy associated with cirrhosis. HE: Hepatic encephalopathy; MHE: Minimal hepatic encephalopathy.

See this image and copyright information in PMC

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References

1. Hadjihambi A, Arias N, Sheikh M, Jalan R. Hepatic encephalopathy a critical current review. Hepatol Int. 2018;12:135–147. - PMC - PubMed
1. Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT. Hepatic encephalopathy--definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 2002;35:716–721. - PubMed
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1. American Association for the Study of Liver Diseases; European Association for the Study of the Liver. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases. J Hepatol. 2014;61:642–659. - PubMed
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[1] Hadjihambi A, Arias N, Sheikh M, Jalan R. Hepatic encephalopathy a critical current review. Hepatol Int. 2018;12:135–147. - PMC - PubMed

[2] Hadjihambi A, Arias N, Sheikh M, Jalan R. Hepatic encephalopathy a critical current review. Hepatol Int. 2018;12:135–147. - PMC - PubMed

[3] Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT. Hepatic encephalopathy--definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 2002;35:716–721. - PubMed

[4] Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT. Hepatic encephalopathy--definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology. 2002;35:716–721. - PubMed

[5] Dhiman RK, Saraswat VA, Sharma BK, Sarin SK, Chawla YK, Butterworth R, Duseja A, Aggarwal R, Amarapurkar D, Sharma P, Madan K, Shah S, Seth AK, Gupta RK, Koshy A, Rai RR, Dilawari JB, Mishra SP, Acharya SK Indian National Association for Study of the Liver. Minimal hepatic encephalopathy: consensus statement of a working party of the Indian National Association for Study of the Liver. J Gastroenterol Hepatol. 2010;25:1029–1041. - PubMed

[6] Dhiman RK, Saraswat VA, Sharma BK, Sarin SK, Chawla YK, Butterworth R, Duseja A, Aggarwal R, Amarapurkar D, Sharma P, Madan K, Shah S, Seth AK, Gupta RK, Koshy A, Rai RR, Dilawari JB, Mishra SP, Acharya SK Indian National Association for Study of the Liver. Minimal hepatic encephalopathy: consensus statement of a working party of the Indian National Association for Study of the Liver. J Gastroenterol Hepatol. 2010;25:1029–1041. - PubMed

[7] American Association for the Study of Liver Diseases; European Association for the Study of the Liver. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases. J Hepatol. 2014;61:642–659. - PubMed

[8] American Association for the Study of Liver Diseases; European Association for the Study of the Liver. Hepatic encephalopathy in chronic liver disease: 2014 practice guideline by the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases. J Hepatol. 2014;61:642–659. - PubMed

[9] Chinese Society of Gastroenterology; Chinese Society of Hepatology, Chinese Medical Association. [Consensus on the diagnosis and treatment of hepatic encephalopathy] Zhonghua Gan Zang Bing Za Zhi. 2013;21:641–651. - PubMed

[10] Chinese Society of Gastroenterology; Chinese Society of Hepatology, Chinese Medical Association. [Consensus on the diagnosis and treatment of hepatic encephalopathy] Zhonghua Gan Zang Bing Za Zhi. 2013;21:641–651. - PubMed

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Chinese guidelines on management of hepatic encephalopathy in cirrhosis

Affiliations

Chinese guidelines on management of hepatic encephalopathy in cirrhosis

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Abstract

Conflict of interest statement

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Abstract

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