Management of liver cirrhosis and its complications

Abstract

Liver cirrhosis is a widespread global health concern with various potential causes, such as chronic viral hepatitis, nonalcoholic fatty liver disease, alcohol consumption, and autoimmune diseases. The development of cirrhosis occurs over an extended period of chronic inflammation, leading to the substitution of healthy liver tissue with fibrotic tissue and regenerative nodules, ultimately leading to the onset of portal hypertension. Decompensated cirrhosis, which arises from a compensated stage, is characterized by the emergence of complications such as ascites, esophageal variceal bleeding, hepatorenal syndrome, hepatic encephalopathy, portal vein thrombosis, and hepatocellular carcinoma, which will result in prolonged hospitalization, impaired quality of life, and poor survival. In recent years, a concept known as “cirrhosis recompensation” has gained prominence in the field of liver cirrhosis. Cirrhosis recompensation, as defined by the Baveno VII consensus criteria, involves three core elements: addressing the underlying etiological factors, achieving remission from complications that are characteristic of the decompensated stage of cirrhosis, and achieving improvements in liver function. Consequently, the management of cirrhosis focuses on the elimination of underlying etiologies, surveillance for hepatocellular carcinoma and esophageal varices, assessment of suitability for liver transplantation, and treatment of complications.