Evidence-based clinical practice guidelines for Liver Cirrhosis 2020

Area of Science:

• Hepatology and Gastroenterology
• Clinical Practice Guidelines
• Liver Disease Management

Background:

• The Japanese Society of Gastroenterology (JSGE) previously published guidelines for liver cirrhosis in 2010 and 2015.
• Significant advancements in understanding and treating liver cirrhosis and its complications have occurred since 2015.
• There is a need to update clinical practice guidelines to reflect new evidence and international standards.

Purpose of the Study:

• To publish the revised third edition of the clinical practice guidelines for liver cirrhosis.
• To incorporate new findings and treatments for liver cirrhosis and its complications.
• To align Japanese guidelines with international standards from organizations like EASL and AASLD.

Main Methods:

• A comprehensive review of recent scientific literature and international guidelines.
• Inclusion of clinical questions (CQs), background questions (BQs), and future research questions (FRQs).
• Focus on evidence-based data relevant to clinical practice in Japan.

Main Results:

• The 2020 guidelines include updated diagnostic algorithms and nutrition therapy flowcharts.
• New treatments for viral and non-viral cirrhosis (ASH/NASH, autoimmune) are detailed.
• Latest evidence on managing complications like ascites, hepatorenal syndrome, hepatic encephalopathy, and portal hypertension is presented.

Conclusions:

• The revised guidelines provide comprehensive, up-to-date information for managing liver cirrhosis.
• The joint publication by JSGE and JSH ensures a unified approach.
• These guidelines aim to improve daily medical care for patients with liver cirrhosis.