Guidelines
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 28, 2019; 25(36): 5403-5422
Published online Sep 28, 2019. doi: 10.3748/wjg.v25.i36.5403
Chinese guidelines on management of hepatic encephalopathy in cirrhosis
Xiao-Yuan Xu, Hui-Guo Ding, Wen-Gang Li, Ji-Dong Jia, Lai Wei, Zhong-Ping Duan, Yu-Lan Liu, En-Qiang Ling-Hu, Hui Zhuang, Chinese Society of Hepatology, Chinese Medical Association
Xiao-Yuan Xu, Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China
Hui-Guo Ding, Hepatology and Digestion Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
Wen-Gang Li, Department of Liver Oncology, Cancer Radiation Therapy Center, Fifth Medical Center, PLA General Hospital, Beijing 100039, China
Ji-Dong Jia, Hepatology Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Lai Wei, Hepatobiliary and Pancreatic Department, Beijing Tsinghua Changgeng Hospital, Beijing 102218, China
Zhong-Ping Duan, Artificial Liver Center, Beijing You-An Hospital, Capital Medical University, Beijing 100069, China
Yu-Lan Liu, Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China
En-Qiang Ling-Hu, Department of Gastroenterology, First Medical Center, PLA General Hospital, Beijing 100853, China
Hui Zhuang, Department of Pathogenic Biology, Peking University Health Science Center, Beijing 100191, China
Author contributions: Xu XY and Duan ZP equally edited and reviewed the manuscript; Li WG, Jia JD, Wei L, Duan ZP, Liu YL, Ling-Hu EQ, and Zhuang H approved the final article.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xiao-Yuan Xu, MD, Professor, Department of Infectious Diseases, Peking University First Hospital, 8 Xishiku Street, Beijing 100034, China. xiaoyuanxu6@163.com
Telephone: +86-10-83575787 Fax: +86-10-83575787
Received: April 26, 2019
Peer-review started: April 26, 2019
First decision: May 30, 2019
Revised: June 7, 2019
Accepted: August 24, 2019
Article in press: August 24, 2019
Published online: September 28, 2019
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: Liver cirrhosis, Hepatic encephalopathy, Diagnosis, Therapy

Core tip: 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.