[Recent advances in the treatment of decompensated liver cirrhosis]

Comprehensive care is required to treat decompensated liver cirrhosis. Fischer's solution and lactulose are usually administered to the patients with hepatic encephalopathy, and improve 98% of those with chronic recurrent type hepatic coma. Benzodiazepine receptor antagonist may be effective to prevent "sensitized brain" in cirrhotics. As to ascites, bed rest, administration of diuretics and albumin infusion improve 88% of the patients. Autoinfusion of filtered and concentrated ascites shows 40% efficacy in patients with ascites, which does not respond to conventional therapy, but is not effective when plasma total bilirubin level is higher than 10 mg/dl. To prevent the development of liver failure in cirrhotic, oral supplementation with branched-chain amino acids is particularly important, in addition to administration of lactulose and prevention of major gastrointestinal bleeding by histamin H2 receptor antagonist and sclerotherapy of esophageal varices.