Management of the major complications of cirrhosis: Beyond guidelines

被引:39
作者
Carlos Garcia-Pagan, Juan [1 ,2 ]
Francoz, Claire [3 ,4 ]
Montagnese, Sara [5 ]
Senzolo, Marco [6 ]
Mookerjee, Rajeshwar P. [7 ,8 ]
机构
[1] Univ Barcelona, Barcelona Hepat Hemodynam Lab, Inst Invest Biomed August Pi & Sunyer IDIBAPs, Liver Unit,Hosp Clin,Ctr Invest Biomed Red Enferm, Barcelona, Spain
[2] Hop Beaujon, Hlth Care Provider European Reference Network Rar, Clichy, France
[3] Hop Beaujon, Hepatol & Liver Intens Care Unit, Clichy, France
[4] INSERM, Paris, France
[5] Univ Padua, Dept Med, Padua, Italy
[6] Univ Hosp Padua, Gastroenterol Multivisceral Transplant Unit, Dept Surg Oncol & Gastroenterol, Padua, Italy
[7] UCL, Inst Liver & Digest Hlth, London NW3 2PF, England
[8] Aarhus Univ, Dept Hepatol & Gastroenterol, Aarhus, Denmark
关键词
Cirrhosis; Decompensation; Management; Guidelines; Controversies; INTRAHEPATIC PORTOSYSTEMIC SHUNT; NONSELECTIVE BETA-BLOCKERS; ACUTE HEMODYNAMIC-RESPONSE; SPONTANEOUS BACTERIAL PERITONITIS; REFRACTORY ASCITES; HEPATIC-ENCEPHALOPATHY; RENAL-FUNCTION; DECOMPENSATED CIRRHOSIS; PROGNOSTIC-SIGNIFICANCE; LIVER-TRANSPLANTATION;
D O I
10.1016/j.jhep.2021.01.027
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Along with a growing understanding of the pathophysiology of cirrhosis and its complications, new therapies and management strategies have emerged in recent years. Many of these advances have helped inform the current EASL clinical practice guidelines(1) on the management of some of the key complications of cirrhosis, such as ascites, variceal bleeding and infection. However, there are still some aspects of management where the evidence base is less clear, and/or where opinions amongst practitioners remain divided. Some of these more controversial areas are explored in this section, wherein we present evidence culminating in a suggested management approach based on expert opinion and extending beyond the current guidelines. (C) 2021 Published by Elsevier B.V. on behalf of European Association for the Study of the Liver.
引用
收藏
页码:S135 / S146
页数:12
相关论文
共 97 条
[1]   Hepatic venous pressure gradient and prognosis in patients with acute variceal bleeding treated with pharmacologic and endoscopic therapy [J].
Abraldes, Juan G. ;
Villanueva, Candid ;
Banares, Rafael ;
Aracil, Carles ;
Catalina, Maria Vega ;
Garcia-Pagan, Juan Carlos ;
Bosch, Jaime .
JOURNAL OF HEPATOLOGY, 2008, 48 (02) :229-236
[2]   A meta-analysis of transjugular intrahepatic portosystemic shunt versus paracentesis for refractory ascites [J].
Albillos, A ;
Bañares, R ;
González, M ;
Catalina, MV ;
Molinero, LM .
JOURNAL OF HEPATOLOGY, 2005, 43 (06) :990-996
[3]   Evaluation of model performance to predict survival after transjugular intrahepatic portosystemic shunt placement [J].
Allegretti, Andrew S. ;
Frenk, Nathan E. ;
Li, Darrick K. ;
Seethapathy, Harish ;
Parada, Xavier F. Vela ;
Long, Joshua ;
Endres, Paul ;
Pratt, Daniel S. ;
Chung, Raymond T. ;
Ganguli, Suvranu ;
Irani, Zubin ;
Yamada, Kei .
PLOS ONE, 2019, 14 (05)
[4]  
Amer Assoc Study Liver Dis, 2014, J HEPATOL, V61, P642, DOI 10.1016/j.jhep.2014.05.042
[6]   Long-term follow-up of hemodynamic responders to pharmacological therapy after variceal bleeding [J].
Augustin, Salvador ;
Gonzalez, Antonio ;
Badia, Laia ;
Millan, Laura ;
Gelabert, Aranzazu ;
Romero, Alejandro ;
Segarra, Antoni ;
Martell, Maria ;
Esteban, Rafael ;
Guardia, Jaime ;
Genesca, Joan .
HEPATOLOGY, 2012, 56 (02) :706-714
[7]   The 3-Month Readmission Rate Remains Unacceptably High in a Large North American Cohort of Patients With Cirrhosis [J].
Bajaj, Jasmohan S. ;
Reddy, K. Rajender ;
Tandon, Puneeta ;
Wong, Florence ;
Kamath, Patrick S. ;
Garcia-Tsao, Guadalupe ;
Maliakkal, Benedict ;
Biggins, Scott W. ;
Thuluvath, Paul J. ;
Fallon, Michael B. ;
Subramanian, Ram M. ;
Vargas, Hugo ;
Thacker, Leroy R. ;
O'Leary, Jacqueline G. .
HEPATOLOGY, 2016, 64 (01) :200-208
[8]   Effect of propranolol on survival in patients with decompensated cirrhosis: a nationwide study based Danish patient registers [J].
Bang, Ulrich C. ;
Benfield, Thomas ;
Hyldstrup, Lars ;
Jensen, Jens-Erik B. ;
Bendtsen, Flemming .
LIVER INTERNATIONAL, 2016, 36 (09) :1304-1312
[9]  
BIANCHI G, 1994, HEPATOLOGY, V20, P119, DOI 10.1016/0270-9139(94)90143-0
[10]   A Smartphone App to Manage Cirrhotic Ascites Among Outpatients: Feasibility Study [J].
Bloom, Patricia ;
Wang, Thomas ;
Marx, Madeline ;
Tagerman, Michelle ;
Green, Bradley ;
Arvind, Ashwini ;
Ha, Jasmine ;
Bloom, Judith ;
Richter, James M. .
JMIR MEDICAL INFORMATICS, 2020, 8 (09)