Hepatic encephalopathy in liver cirrhosis

Djiambou-Nganjeu, Herbert

doi:10.1515/jtim-2017-0013

Cited by 13 publications

(11 citation statements)

References 8 publications

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“…After the metal stent is placed, tumor invasion or overgrowth, bile accumulation, or biofilm formation may cause clogging in the stent. In this study, the median patency time of a simple metal stent was 7 mo in patients with high biliary obstruction, which is similar to that of other previous studies[16,17,29,30](7-9 mo).…”

Section: Discussionsupporting

confidence: 90%

“…Obstructive jaundice is a common clinical symptom of hilar cholangiocarcinoma. Persistent biliary obstruction can lead to liver failure, secondary renal failure[27,28], severe hypoproteinemia, electrolyte imbalance, septic shock, etc ., affecting the quality of life and survival of patients[16,29,30]. Clinically, percutaneous drainage tube or biliary stent implantation in various ways is an effective treatment for obstructive jaun-dice[17,31-39].…”

Section: Discussionmentioning

confidence: 99%

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Clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization combined with radiotherapy in hilar cholangiocarcinoma

Wei

Luo

et al. 2019

WJGO

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BACKGROUND Radical surgical resection is regarded as the best treatment for hepatic hilar cholangiocarcinoma. However, 60%-70% of patients have lost the chance of surgery at the time of diagnosis. Simple biliary stent or drainage tube placement may fail in a short time due to tumor invasion or overgrowth, bile accumulation, or biofilm formation. Effective palliative treatments to extend the effective drainage time are of great significance for improving the quality of life of patients and changing the prognosis of patients. AIM To investigate the clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization (TACE) combined with radiotherapy in hilar cholangiocarcinoma. METHODS A retrospective analysis was conducted on patients clinically diagnosed with hilar cholangiocarcinoma from June 2014 to January 2017 at the Liaoning Provincial Cancer Hospital. Patients were evaluated by specialists, and those who were not suitable for surgery or unwilling to undergo surgery and met the inclusion criteria were included in the study. There were a total of 72 patients (34 males and 38 females) with an average age of 59.9 years (range, 40-72 years). According to percutaneous transhepatic biliary angiography and the patients’ wishes, stent implantation or biliary drainage tube implantation was used to relieve biliary obstruction. The patients were divided into either a control group or a combined treatment group according to their follow-up treatment. The control group consisted of a total of 35 patients who received simple biliary drainage tube placement and biliary stent implantation (7 patients with bilateral stents and 6 with a unilateral stent) and 22 patients receiving biliary drainage tube placement alone. The combined treatment group received TACE and extracorporeal radiotherapy after biliary drainage or biliary stent implantation and consisted of a total of 37 patients, including 21 patients receiving combined treatment after biliary stent placement (14 patients with bilateral stents and 7 with a unilateral stent) and 16 undergoing combined therapy after implanting the biliary drainage tube. In the combination treatment group, the TACE chemotherapy regimen employed gemcitabine and cisplatin, and the embolic agent was iodized oil. A particular dose was determined according to the patient's body surface area and the tumor staining indicated by DSA. In vitro radiotherapy was performed with intensity-modulated radiotherapy or three-dimensional conformal radiotherapy at an average dose of 48.3 Gy. Both groups were followed from stent implantation or drainage tube implantation until the patient quitted or died. The median length of follow-up observation was 13 mo. The differences in overall survival time and the effect of different jaundice reducing methods (single stent, double stent, or biliary drainage) on the patency time and survival time of biliary stents were compared between the two ...

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization combined with radiotherapy in hilar cholangiocarcinoma

Wei

Luo

et al. 2019

WJGO

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“…Similarly, prolongation of INR has been observed in studies conducted in the USA and HE with liver cirrhosis in Ukraine (15,16). Similarly, in the study conducted by Koch et al, the INR level was found to be longer than normal in cases with HE resulting in death (16).…”

Section: Discussionmentioning

confidence: 51%

“…Our study includes patients with chronic liver disease who developed HE due to acute failure. In other studies from Ukraine and America, ALT and AST values were found to be increased when blood ammonia level increased (15,16).…”

Section: Discussionmentioning

confidence: 62%

Retrospective Evaluation of the Effect of Ammonia Levels on Mortality in Patients With Hepatic Encephalopathy Applying to the Emergency Department

GÜNGÖR

Erdem²

2021

Kırıkkale Üniversitesi Tıp Fakültesi Dergisi

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Objective: Hepatic encephalopathy is a cognitive, motor and behavioral disorder caused by the accumulation of liver metabolism products accompanying hepatic failure. The clinical picture of hepatic encephalopathy appears with the accumulation of metabolites such as ammonia and gamma aminobutyric acid. In our study, we aimed to investigate the effect of blood ammonia levels on mortality in patients diagnosed with hepatic encephalopathy. Material and Methods: The records of patients who were admitted to the emergency department of our hospital with impaired consciousness, known chronic liver disease, and whose ammonia levels were studied between January 01 2015 and December 31 2018 were retrospectively analyzed. Liver function tests and coagulation tests of the patients were recorded. The patients were divided into two groups as with and without hepatic encephalopathy. The groups were divided into stages according to the West Haven classification. Liver function tests and coagulation tests of the two groups were compared according to ammonia level, disease stage and mortality.

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“…The aetiology of cirrhosis varies geographically with Alcoholic liver disease, Chronic Hepatitis C Virus (HCV) infection, and nonalcoholic fatty lives disease (NAFLD) being the most common causes in western countries, whereas chronic hepatitis B and C are the primary cause of liver cirrhosis in the Asia-Pacific region. 1,2 Liver cirrhosis is associated with a number of complications that can even lead to mortality but the most common complication is portosystemic encephalopathy that results in significant mortality. 3 Hepatic encephalopathy is defined as a spectrum of neuropsychiatric abnormalities in patients with liver dysfunction, after exclusion of other known brain diseases.…”

Section: Introductionmentioning

confidence: 99%

Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy

Hussain¹,

Sattar²,

Mustafa³

et al. 2020

JRMC

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Background: Hepatic Encephalopathy is a syndrome observed in patients with liver cirrhosis. Various treatment modalities are in use for treatment of Porto Systemic Encephalopathy (PSE). Our study aimed to compare the efficacy of Rifaximin plus Lactulose vs.Lactulose alone in treating Hepatic Encephalopathy in local population. Materials & Methods: The study was conducted at a tertiary care hospital recruiting decompensated chronic liver disease(DCLD) patients with PSE. Using simple random sampling, patients were divided in two groups (A & B). Patients in group A received Lactulose plus Rifaximin while group B received Lactulose alone. Efficacy of treatment was assessed as return of the conscious level to pre-encephalopathy state as per clinical examination within 1 week after start of the treatment. Results: A total of 124 patients were included in the study with each group (A & B) containing 62 patients. Frequency and percentage of efficacy among group A (Rifaximin plus Lactulose) verses group B (Lactulose alone) in treating Hepatic encephalopathy was 45 (72.6%) and 32 (51.6%) respectively. Conclusion: The study concluded that there is a significant difference in proportions of patients showing complete recovery from Hepatic encephalopathy treated with Lactulose plus Rifaximin as compared to Lactulose alone.

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Hepatic encephalopathy in liver cirrhosis

Cited by 13 publications

References 8 publications

Clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization combined with radiotherapy in hilar cholangiocarcinoma

Clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization combined with radiotherapy in hilar cholangiocarcinoma

Retrospective Evaluation of the Effect of Ammonia Levels on Mortality in Patients With Hepatic Encephalopathy Applying to the Emergency Department

Comparing efficacy of Rifaximin plus Lactulose vs. Lactulose alone in treating Hepatic Encephalopathy

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