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Diagnosis of cirrhosis and portal hypertension:imaging,non-invasive markers of fibrosis and liver biopsy

Gastroenterology Report 2017年第2期5卷 79-89,I0001页

作者： Bogdan Procopet Annalisa Berzigotti University of Medicine and Pharmacy‘Iuliu Hatieganu’ 3rd Medical Clinic and Hepatology DepartmentRegional Institute of Gastroenterology and Hepatology‘O Fodor’Cluj-NapocaRomania Swiss liver Center HepatologyUniversity Clinic for Visceral Surgery and MedicineInselspitalUniversity of BernBernSwitzerland

The concept of‘cirrhosis’is evolving and it is now clear that compensated and decompensated cirrhosis are completely different in terms of ***,the term‘advanced chronic liver disease(ACLD)’better reflects the continuum of histological changes occurring in the liver,which continue to progress even after cirrhosis has developed,and might regress after removing the etiological factor causing the liver *** compensated ACLD,portal hypertension marks the progression to a stage with higher risk of clinical complication and requires an appropriate evaluation and *** tests to diagnose cirrhosis(liver biopsy)and portal hypertension(hepatic venous pressure gradient measurement and endoscopy)remain of crucial importance in several difficult clinical scenarios,but their need can be reduced by using different non-invasive tests in standard *** non-invasive tests,the accepted use,major limitations and major benefits of serum markers of fibrosis,elastography and imaging methods are summarized in the present review.

关键词： compensated advanced chronic liver disease hepatic venous pressure gradient elastography ultrasound

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compensated liver cirrhosis:Natural course and disease-modifying strategies

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World Journal of Methodology 2023年第4期13卷 179-193页

作者： Ramesh Kumar Sudhir Kumar Sabbu Surya Prakash Department of Gastroenterology All India Institute of Medical SciencesPatna 801507India

compensated liver cirrhosis(CLC)is defined as cirrhosis with one or more decompensating events,such as ascites,variceal haemorrhage,or hepatic *** with CLC are largely asymptomatic with preserved hepatic *** transition from CLC to decompensated cirrhosis occurs as a result of a complex interaction between multiple predisposing and precipitating *** first decompensation event in CLC patients is considered a significant turning point in the progression of cirrhosis,as it signals a drastic decline in median survival rates from 10-12 years to only 1-2 ***,early cirrhosis has the potential to regress as liver fibrosis is a dynamic *** the advent of effective non-invasive tools for detecting hepatic fibrosis,more and more patients with CLC are currently being *** offers clinicians a unique opportunity to properly manage such patients in order to achieve cirrhosis regression or,at the very least,prevent its *** are numerous emerging approaches for preventing or delaying decompensation in CLC patients.A growing body of evidence indicates that treating the underlying cause can lead to cirrhosis regression,and the use of non-selective beta-blockers can prevent decompensation by lowering portal ***,address-ing various cofactors(such as obesity,diabetes,dyslipidaemia,and alcoholism)and precipitating factors(such as infection,viral hepatitis,and hepatotoxic drugs)that have a detrimental impact on the natural course of cirrhosis may benefit patients with ***,high-quality data must be generated through well-designed and adequately powered randomised clinical trials to validate these diseasemodifying techniques for CLC *** article discussed the natural history of CLC,risk factors for its progression,and therapeutic approaches that could alter the trajectory of CLC evolution and improve outcomes.

关键词： compensated cirrhosis compensated advanced chronic liver disease Clinical decompensation Cirrhosis reversal disease-modifying agents Acute-on-chronic liver failure

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