Cirrhosis of the liver – Related resources
26.02.2016 • Sonuncu dəyişiklik 15.03.2010
This article is created and updated by the EBMG Editorial Team
Cochrane reviews
- In patients hospitalized for alcoholic liver disease, parenteral nutrition may result in larger reduction of serum bilirubin. It might possibly reduce mortality, ascites and hepatic encephalopathy, but the evidence is insufficient for conclusions .
- Probiotics might possibly have no effect on clinically important outcomes in treating patients with hepatic encephalopathy, but the evidence is insufficient.
- There is insufficient evidence of the effects of antioxidant supplements in patients with liver disease. Antioxidant supplements may increase liver enzyme activity .
- Antibiotic prophylaxis (for 7 days) reduces the occurrence of infections and probably improves survival in cirrhotic patients with gastrointestinal bleeding .
- Anabolic-androgenic steroids appear not to be effective for alcoholic liver disease .
- Dopaminergic agonists are probably not effective for patients with acute or chronic hepatic encephalopathy, or fulminant hepatic failure .
- Terlipressin may reduce mortality and improve renal function in hepatorenal syndrome .
- Antibiotic prophylaxis may prevent spontaneous bacterial peritonitis and improve survival in cirrhotic patients with ascites and without gastro-intestinal bleeding .
- Pentoxifylline may reduce short-term mortality in patients with severe alcoholic hepatitis .
Other evidence summaries
- Sclerotherapy appears to be more effective than propranolol in the prevention of variceal rebleeding but have more adverse effects .
- Sclerotherapy for oesophageal varices is more effective than placebo in reducing total mortality .
- A considerable proportion of patients with alcoholic hepatitis appear to benefit from a one-month course of 40 mg of prednisolone a day .
- Liver transplantation with adjuvant chemotherapy is effective in patients with advanced cirrhosis and small tumours. In unresectable tumours arterial chemoembolization and percutaneous ethanol injections may icrease disease-free survival .
- The platelet count/spleen diameter ratio (PC/SD) appears to predict the presence of oesophageal varices. A PC/SD > 909 practically rules out oesophageal varices .
Literature
- Promrat K, Kleiner DE, Niemeier HM, Jackvony E, Kearns M, Wands JR, Fava JL, Wing RR. Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis. Hepatology 2010 Jan;51(1):121-9.
- Schuppan D, Afdhal NH. Liver cirrhosis. Lancet 2008 Mar 8;371(9615):838-51.
- Rössle M, Ochs A, Gülberg V, Siegerstetter V, Holl J, Deibert P, Olschewski M, Reiser M, Gerbes AL. A comparison of paracentesis and transjugular intrahepatic portosystemic shunting in patients with ascites. N Engl J Med 2000 Jun 8;342(23):1701-7.