KASL clinical practice guidelines for liver cirrhosis: Varices, hepatic encephalopathy, and related complications
Unknown author
Abstract
Patients with decompensated cirrhosis with complications have a very poor prognosis and require careful management. Varices are common complications in patients with cirrhosis. Although the prognosis of variceal bleeding has improved with recent advances in diagnosis and treatment, the mortality rate remains 12-22%. Hepatic encephalopathy (HE) is known to occur in 10-14% of patients with cirrhosis and 16-21% of patients with decompensated cirrhosis. More than 20% of cirrhotic patients who visit emergency rooms in Korea present with HE. Therefore, cirrhosis is a serious disease in Korea and requires specific Korean guidelines for diagnosis, treatment, and prevention. In 2005, the Korean Association for the Study of the Liver (KASL) enacted a clinical practice guideline (CPG) for the treatment of cirrhosis complications including ascites, hepatorenal syndrome, varices, and HE. In 2011, the guidelines for the treatment of cirrhosis were revised to integrate antifibrotic treatment and update the diagnosis and treatment advice for variceal bleeding, cirrhotic ascites, and HE. In 2017, the CPG for liver cirrhosis was revised for ascites and related complications. At this time, KASL is revising the CPG for liver cirrhosis to address varices and HE following ascites and related complications. To date, many studies have addressed the prevention and treatment of gastroesophageal variceal bleeding and HE, and many guidelines have been based on those studies, but most of them contain foreign data that are difficult to apply to Korean