Hepatic Encephalopathy

Zakim and Boyer's Hepatology

Volumn , Issue , 2006, Pages 311-331

  Mullen, Kevin D ^a,b  

^a CASE WESTERN RESERVE UNIVERSITY   (United States)

^b METROHEALTH MEDICAL CENTER   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

EID: 84882912407     PISSN: None     EISSN: None     Source Type: Book    
DOI: 10.1016/B978-1-4160-3258-8.50023-1     Document Type: Chapter

References (255)

1. Adams RD, Foley JM The neurological changes in the more common types of severe liver disease. Trans Am Neurol Assoc 1949, 74:217-219.
2. Adams RD, Foley JM The neurological disorder associated with liver disease. Proc Assoc Res Nerv Ment Dis 1953, 32:1198-1237.
3. Summerskill WHJ, Davidson EA, Sherlock S, Steiner RE The neuropsychiatric syndrome associated with hepatic cirrhosis and/or extensive portal collateral circulation. Q J Med 1956, 25:245-266.
4. Mullen KD Terminology of hepatic encephalopathy: Work in progress. Advances in hepatic encephalopathy and metabolism in liver disease 2000, 375-380. Ankara University Press, Ankara. C. Yurdaydin, H. Bozkaya (Eds.).
5. Ferenci P, Lockwood A, Mullen K, et al. Hepatic encephalopathy - definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congress of Gastroenterology, Vienna, 1998. Hepatology 2002, 35:716-721.
6. Arroyo V, Gines P, Gerbes AL, et al. Definition and diagnostic criteria of refractory ascites and hepatorenal syndrome in cirrhosis. International Ascites Club. Hepatology 1996, 23:164-176.
7. McDermott WV, Adams RD Episodic stupor associated with Eck fistula in the human with particular reference to the metabolism of ammonia. J Clin Invest 1954, 33:1-9.
8. Ferenci P, Grimm G, Meryn S, Gangl A. Successful long term therapy of portal-systemic encephalopathy by the benzodiazepine antagonist flumazenil. Gastroenterology 1989, 96:240-243.
9. Mullen KD Interplay of portal pressure, portal perfusion and hepatic arterial inflow in patients with spontaneous or artificially created portosystemic shunts. Indian J Gastroenterol 2003, 22(Suppl 2):S25-S27.
10. Zeneroli ML, Cioni G, Vezzelli C, et al. Prevalence of brain atrophy in liver cirrhosis patients with chronic persistent encephalopathy. Evaluation by computed tomography. J Hepatol 1987, 4:283-292.
11. Zeneroli ML, Cioni G, Crisi G, et al. Globus pallidus alterations and brain atrophy in liver cirrhosis patients with encephalopathy: an MR imaging study. Magn Reson Imag 1991, 9:295-302.
12. Mullen KD, Cole M, Foley JM Neurological deficits in 'awake' cirrhotic patients on hepatic encephalopathy treatment: missed metabolic or metal disorder?. Gastroenterology 1996, 111:256-257.
13. 1 weighted magnetic resonance images in liver cirrhosis. Gastroenterology 1996, 111:147-155.
14. Victor M, Adams RD, Cole M The acquired (non-Wilsonian) type of chronic hepatocerebral dysfunction. Medicine 1965, 44:345-396.
15. Powell EE, Pender MP, Chalk JB, et al. Improvement in chronic hepatocerebral degeneration following liver transplantation. Gastroenterology 1990, 98:1079-1082.
16. Gabuzda GJ, Phillips GB, Davidson CS Reversible toxic manifestations in patients with cirrhosis of the liver given cation exchange resions. N Engl J Med 1952, 246:124-130.
17. Phillips GB, Schartze R, Gabuzda GJ, Davidson CS Syndrome of impending coma in patients with cirrhosis of the liver given certain nitrogenous substances. N Engl J Med 1952, 247:239-246.
18. Schwartz R, Phillips G, Seegmiller JE, et al. Dietary protein in the genesis of hepatic coma. N Engl J Med 1954, 251:685-689.
19. Stahl J. Studies of blood ammonia in liver disease. Ann Intern Med 1963, 98:1-24.
20. Muting D, Kalk JF, Koussouris P, et al. The role of protein metabolism in 204 liver cirrhotics with and without hepatic encephalopathy. I. Clinical and general biochemical findings. Hepatogastroenterology 1986, 33:61-65.
21. Kramer L, Tribl B, Gendo A, et al. Partial pressure of ammonia versus ammonia in hepatic encephalopathy. Hepatology 2000, 31:30-34.
22. Ong JP, Aggarawal A., Krieger D, et al. Correlation between ammonia levels and the severity of hepatic encephalopathy. Am J Med 2003, 114:188-193.
23. Nicolao F, Ferati C, Masini A, et al. Role of determination of portal pressure of ammonia in cirrhotic patients with and without hepatic encephalopathy. J Hepatol 2003, 38:441-446.
24. Cooper AJL, Plum F Biochemistry and physiology of brain ammonia. Physiol Rev 1987, 67:440-519.
25. Msall M, Batshaw ML, Suss R, et al. Neurologic outcome in children with inborn errors of urea synthesis. Outcome of urea-cycle enzymopathies. N Engl J Med 1984, 310:1500-1505.
26. Iles JF, Jack JJB Ammonia: assessment of its action on postsynaptic inhibitions as a cause of convulsions. Exp Brain Res 1970, 11:431-437.
27. Eichler M, Bessman SP A double-blind study of the effects of ammonium infusion or psychological functioning in cirrhotic patients. J Nerv Ment Dis 1962, 134:539-542.
28. Cohn R, Castell DO The effect of acute hyperammonemia on the electroencephalogram. J Lab Clin Med 1982, 2:495-506.
29. Gitlin N. Hepatic encephalopathy. Hepatology. A textbook of liver disease 1996, 605-617. WB Saunders, Philadelphia. D. Zakim, T.D. Boyer (Eds.).
30. Blei A. Hepatic encephalopathy. Clinical hepatology 1999, 765-783. Oxford University Press, Oxford. J. Bircher, J.P. Benhamou, N. McIntyre (Eds.).
31. Butterworth RF The neurobiology of hepatic encephalopathy. Semin Liver Dis 1996, 16:235-244.
32. Ferenci P, Puspok A, Steindl P. Current concepts in the pathophysiology of hepatic encephalopathy. Eur J Clin Invest 1992, 22:573-581.
33. Haussinger D, Kircheis G, Fischer R, et al. Hepatic encephalopathy in chronic liver disease: a clinical manifestation of astrocyte swelling and low-grade cerebral edema?. J Hepatol 2000, 32:1035-1038.
34. Blei AT Pathophysiology of brain edema in fulminant hepatic failure, revisited. Metab Brain Dis 2001, 16:85-94.
35. Ross BD, Jacobson S, Villamil F, et al. Subclinical hepatic encephalopathy: proton MR spectroscopic abnormalities. Radiology 1994, 193:457-463.
36. Cordoba J, Alonso J, Rovira A, et al. The development of low-grade cerebral edema in cirrhosis is supported by the evolution of (1)H-magnetic resonance abnormalities after liver transplantation. J Hepatol 2001, 35:598-604.
37. Jayakumar AR, Rama Rao KV, Kalaiselvi P, Norenberg MD Combined effects of ammonia and manganese on astrocytes in culture. Neurochem Res 2004, 29:2051-2056.
38. Butterworth RF The astrocytic (peripheral type) benzodiazepine receptor: Role in pathogenesis of portal-systemic encephalopathy. Neurochem Int 2000, 36:411-416.
39. Norenberg MD The role of astrocytes in hepatic encephalopathy. Neurochem Pathol 1987, 6:13-33.
40. Norenberg MD Astrocyte-ammonia interactions in hepatic encephalopathy. Semin Liver Dis 1996, 216:243-245.
41. Zieve L, Doizaki WM, Zieve FJ Synergism between mercaptans and ammonia and fatty acids in the production of coma, a possible role for mercaptans in the pathogenesis of hepatic coma. J Lab Clin Med 1974, 83:16-28.
42. Blom HJ, Chamuleau RA, Rothwizer J, et al. Methanethiol metabolism and its role in the pathogenesis of hepatic encephalopathy in rats and dogs. Hepatology 1990, 11:682-689.
43. Blom HJ, Ferenci P, Grimm G, et al. The role of methanethiol on the pathogenesis of HE. Hepatology 1991, 13:445-454.
44. Fischer JE, Baldessari RJ False neurotransmitters and hepatic failure. Lancet 1971, 2:75-79.
45. Zieve L, Olsen RL Can hepatic coma be caused by a reduction of brain noradrenaline in dopamine?. Gut 1977, 18:688-691.
46. James JH, Zipparo V, Jeppson B, Fischer JE Hyperammonemia, plasma amino acid imbalance and blood-brain amino acids transport: a unified theory of portal-systemic encephalopathy. Lancet 1979, 2:772-775.
47. Sato S, Watanabe A, Muto Y, et al. Effect of oral branched chain amino acid granules on event free survival in patients with liver cirrhosis. Clin Gastroenterol Hepatol 2005, 3:705-713.
48. Schafer DF, Jones EA Hepatic encephalopathy and the γ-aminobutyric acid neurotransmitter system. Lancet 1982, 1:18-19.
49. Mullen KD, Martin JV, Mendelson WB, et al. Could an endogenous benzodiazepine ligand contribute to hepatic encephalopathy?. Lancet 1988, 27(1):457-459.
50. Bassett ML, Mullen KD, Skolnick P, Jones EA Amelioration of hepatic encephalopathy by pharmacological antagonists of the GABAA-benzodiazepine reception complex in a rabbit model of fulminant hepatic failure. Gastroenterology 1987, 93:1069-1077.
51. Baraldi M, Zeneroli ML, Ventura E, et al. Supersensitivity of benzodiazepine receptors in hepatic encephalopathy due to fulminant hepatic failure in the rat: reversal by a benzodiazepine antagonist. Clin Sci (Lond) 1984, 67:167-175.
52. Barbaro G, Di Lorenzo G, Soldini M, et al. Flumazenil for hepatic coma in patients with liver cirrhosis: an Italian multicentre double-blind, placebo-controlled, crossover study. Eur J Emerg Med 1998, 5:213-218.
53. Pomier-Layrargues G, Giguere JF, Lavoie J, et al. Flumazenil in cirrhotic patients in hepatic coma: a randomized double-blind placebo-controlled crossover trial. Hepatology 1995, 21:604-605.
54. Kapczinski F, Sherman D, Williams R, et al. Differential effects of flumazenil in alcoholic and nonalcoholic cirrhotic patients. Psychopharmacology Berlin 1995, 120:220-226.
55. Cadranel JF, el Younsi M, Pidoux B, et al. Flumazenil therapy for hepatic encephalopathy in cirrhotic patients: a double-blind pragmatic randomized, placebo study. Eur J Gastroenterol Hepatol 1995, 7:325-329.
56. Gyr K, Meier R, Haussler J, et al. Evaluation of the efficacy and safety of flumazenil in the treatment of portal systemic encephalopathy: a double blind, randomized, placebo controlled multicentre study. Gut 1996, 39:319-324.
57. Zhu C, Wang J, Liu T. Flumazenil in the treatment of cirrhotic patients with hepatic encephalopathy: A randomized double-blind clinical trial. Chin J Digestion 1998, 18:355-358.
58. Laccetti M, Manes G, Uomo G, et al. Flumazenil in the treatment of acute hepatic encephalopathy in cirrhotic patients: a double blind randomized placebo controlled study. Dig Liver Dis 2000, 32:335-338.
59. Dursun M, Caliskan M, Canoruc F, et al. The efficacy of flumazenil in subclinical to mild hepatic encephalopathic ambulatory patients. A prospective, randomised, double-blind, placebo-controlled study. Swiss Med Wkly 2003, 133:118-123.
60. Mullen KD, Jones EA Natural benzodiazepines and hepatic encephalopathy. Semin Liver Dis 1996, 16:255-264.
61. Yurdaydin C, Walsh TJ, Engler HD, et al. Gut bacteria provide precursors of benzodiazepine receptor ligands in a rat model of hepatic encephalopathy. Brain Res 1995, 679:42-48.
62. Aronson LR, Gacad RC, Kaminsky-Russ K, et al. Endogenous benzodiazepine activity in the peripheral and portal blood of dogs with congenital portosystemic shunts. Vet Surg 1997, 26:189-194.
63. Zeneroli ML, Venturini I, Stefanelli S, et al. Antibacterial activity of rifaximin reduces the levels of benzodiazepine-like compounds in patients with liver cirrhosis. Pharmacol Res 1997, 35:557-560.
64. Pomier-Layrargues G, Shepcott D, Spahn L, Butterworth RF Accumulation of manganese and copper in palladium of cirrhotic patients: role in the pathogenesis of hepatic encephalopathy?. Metab Brain Dis 1995, 10:351-354.
65. Krieger D, Krieger S, Jansen O, et al. Manganese and chronic hepatic encephalopathy. Lancet 1995, 346:270-274.
66. Yurdaydin C. The central opioid system in liver disease and its complications. Metab Brain Dis 2001, 16:79-83.
67. Ozsoylu S, Kocak N. Naloxone in hepatic encephalopathy. Am J Dis Child 1985, 139:749-750.
68. Bergasa NV, Thomas DA, Vergalla J, et al. Plasma from patients with the pruritus of cholestasis induces opioid receptor-mediated scratching in monkeys. Life Sci 1993, 53:1253-1257.
69. Bergasa NV, Alling DW, Talbot TL, et al. Effects of naloxone infusions in patients with the pruritus of cholestasis. A double-blind, randomized, controlled trial. Ann Intern Med 1995, 123:161-167.
70. Ahbouche S, Butterworth RF Pathophysiology of hepatic encephalopathy: a new look at GABA from the molecular standpoint. Metab Brain Dis 2004, 19:331-343.
71. Ahbouche S, Pomier-Layrargues C, Butterworth RF Increased brain concentration of endogenous (non-benzodiazepine) GABA-A receptor ligands in human hepatic encephalopathy. Metab Brain Dis 2004, 19:241-251.
72. Butterworth RK Neurotransmitter dysfunction in hepatic encephalopathy. New approaches and new findings. Metab Brain Dis 2001, 16:55-65.
73. Basile AS, Jones EA, Skolnick P The pathogenesis and treatment of hepatic encephalopathy: Evidence for the involvement of benzodiazepine receptor ligands. Pharmacol Rev 1991, 43:27-71.
74. Conn H, Lieberthal M. The hepatic coma syndromes and lactulose 1979, Williams & Wilkins, Baltimore.
75. Cordoba J, Gottstein J, Blei AT Chronic hyponatremia exacerbates ammonia-induced brain edema in rats after portacaval anastomosis. J Hepatol 1998, 29:589-594.
76. van Berlo CL, van de Bogaard AE, van der Heijden MA, et al. Is increased ammonia liberation after bleeding in the digestive tract the consequence of complete absence of isoleucine in hemoglobin? A study in pigs. Hepatology 1989, 10:315-323.
77. Olde Damink SWM, Jalan R, Dejong CHC, et al. Metabolic consequences of an upper gastrointestinal bleed in patients with cirrhosis. Encephalopathy and nitrogen metabolism in liver failure 2003, 21-29. Kluwer Academic, Dordrecht. E.A. Jones, A.J. Meijer, R.A.F.M. Chamuleau (Eds.).
78. Gentile S, Guarino G, Romano M, et al. A randomized controlled trial of acarbose in hepatic encephalopathy. Clin Gastroenterol Hepatol 2005, 3:184-191.
79. Spahr L, Vingerhoets F, Lazeyras F, et al. Magnetic resonance imaging and proton spectroscopic alterations correlate with parkinsonian signs in patients with cirrhosis. Gastroenterology 2000, 119:774-781.
80. Jover R, Company L, Gutierrez A, et al. Minimal hepatic encephalopathy and extrapyramidal signs in patients with cirrhosis. Am J Gastroenterol 2003, 98:1599-1604.
81. Parsons-Smith BG, Summerskill WHJ, Dawson AM, Sherlock S. The electroencephalogram in liver disease. Lancet 1957, 2867-2871.
82. Vaquero J, Oliver D, Hassanein T, et al. Evaluation of mental state in a clinical trial of MARS for patients with acute hepatic encephalopathy: Comparison of two scales. Encephalopathy and nitrogen metabolism in liver failure 2003, 55-69. Kluwer Academic, Dordrecht. E.A. Jones, A.J. Meijer, R.A.F.M. Chamuleau (Eds.).
83. Donovan JP, Schafer DF, Shaw BW, Sorrell MF Cerebral oedema and increased intracranial pressure in chronic liver disease. Lancet 1998, 7(351):719-721.
84. Candranel JF, Lebietz E, DiMartino V, et al. Focal neurological signs in hepatic encephalopathy in cirrhotic patients: underestimated entity?. Am J Gastroenterol 2001, 96:515-518.
85. Mullen KD, Dasarathy S Hepatic encephalopathy. Schiffs Diseases of the liver 1999, 545-581. Lippincott Raven, Philadelphia. 8th edn. E.R. Schiff, M.F. Sorrell, W.C. Maddrey (Eds.).
86. Weissenborn K, Scholz M, Hinrichs H, et al. Neurophysiological assessment of early hepatic encephalopathy. Electroencephalogr Clin Neurophysiol 1990, 75:289-295.
87. Van der Rijt CC, Schalm SW, deGroot AH, deKlieger M Objective measurement of hepatic encephalopathy by means of automated EEG analysis. Electroencephalogr Clin Neurophysiol 1989, 57:423-426.
88. Brenner RP The electroencephalogram in altered states of consciousness. Neurol Clin 1985, 3:615-631.
89. Bickford RG, Butt HR Hepatic coma: the electroencephalographic pattern. J Clin Invest 1955, 34:790-799.
90. Nolano M, Guardascione MA, Amitrano L, et al. Cortico-spinal pathways and inhibitory mechanisms in hepatic encephalopathy. Electroencephalogr Clin Neurophysiol 1997, 105:72-78.
91. Sanford SL, Tarter RE, Sclabassi R, Van Theil DH Sensory information processing in patients with non-alcoholic cirrhosis: short latency, visual, auditory, and somatosensory event related potentials. J Neurol Sci 1987, 80:269-276.
92. Kullman F, Hollerbach S, Holstege A, Scholmerich J. Subclinical hepatic encephalopathy: the diagnostic value of evoked potentials. J Hepatol 1995, 22:101-110.
93. Cordoba J, Raguer N, Flavia M, et al. T2 hyperintensity along the cortico-spinal tract in cirrhosis relates to functional abnormalities. Hepatology 2003, 38:1026-1033.
94. Kircheis G, Wettstein M, Timmermann L, et al. Critical flicker frequency for quantification of low-grade hepatic encephalopathy. Hepatology 2002, 35:357-366.
95. Bakti G, Fisch HU, Karlaganis G, et al. Mechanism of the excessive sedative response of cirrhotics to benzodiazepines: model experiments with triazolam. Hepatology 1987, 7:629-638.
96. Morgan MY Non-invasive neuro investigation in liver disease. Sem Liv Dis 1996, 16:293-314.
97. Brunberg JA, Kanal E, Hirsch W, Van Thiel DH Chronic acquired hepatic failure: MR imaging of the brain at 1.5T. Am J Neuroradiol 1991, 12:909-914.
98. Inoue E, Hori S, Narumi Y, et al. Portal-systemic encephalopathy: presence of basal ganglia lesions with high signal intensity on MR images. Radiology 1991, 179:551-555.
99. Pujol A, Pujol J, Graus F, et al. Hyperintense globus pallidus on T1-weighted MRI in cirrhotic patients is associated with severity of liver failure. Neurology 1993, 43:65-69.
100. Syh HW, Chu WK, Mar N, McConnell JR An image analysis on MR imaging of the brain for hepatic encephalopathy. Biomed Sci Instrum 1991, 27:29-33.
101. Kulisevsky J, Pujol J, Balanzo J, et al. Pallidal hyperintensity on magnetic resonance imaging in cirrhotic patients: clinical correlations. Hepatology 1992, 16:1382-1388.
102. Norton NS, McConnell JR, Zetterman RK, Rodriguez-Sierra JF A quantitative evaluation of magnetic resonance image signal changes of the brain in chronic hepatic encephalopathy. J Hepatol 1994, 21:764-770.
103. Taylor-Robinson SD, Oatridge A, Hajnal JV, et al. MR imaging of the basal ganglia in chronic liver disease: correlation of T1-weighted and magnetization transfer contrast measurements with liver dysfunction and neuropsychiatric status. Metab Brain Dis 1995, 10:175-188.
104. Thuluvath PJ, Edwin D, Yue NC, et al. Increased signals seen in globus pallidus in T1-weighted magnetic resonance imaging in cirrhotics are not suggestive of chronic hepatic encephalopathy. Hepatology 1996, 24:282-283.
105. Bernthal P, Hays A, Tarter RE, et al. Cerebral CT scan abnormalities in cholestatic and hepatocellular disease and their relationship to neuropsychologic test performance. Hepatology 1987, 7:107-114.
106. Kanamori K, Blumi S, Ross B. Magnetic resonance spectroscopy in the study of hyperammonemia and hepatic encephalopathy. Advances in cirrhosis, hyperammonemia and hepatic encephalopathy 1997, 185-194. Plenum Press, New York. V. Felipo, S. Grisolia (Eds.).
107. Ross BD, Danielson ER, Blumi S Proton magnetic resonance spectroscopy: the new gold standard for diagnosis of clinical and subclinical hepatic encephalopathy. Dig Dis Sci 1996, 4(Suppl 1):30-39.
108. Lockwood AH, Yap EWH, Rhoades HM, Wong WH Altered cerebral blood flow and glucose metabolism in patients with liver disease and minimal encephalopathy. J Cerebr Blood Flow Metab 1991, 11:331-336.
109. O'Carroll RE, Hayes PC, Ebmeier KP, et al. Regional cerebral blood flow and cognitive function in patients with chronic liver disease. Lancet 1991, 337:1250-1253.
110. Trzepacz PT, Tarter RE, Shah A, et al. SPECT scan and cognitive findings in subclinical hepatic encephalopathy. J Neuropsychiatry Clin Neurosci 1994, 6:170-175.
111. Kawatoko T, Murai K, Ibayashi S, et al. Marked reduction of cerebral oxygen metabolism in patients with advanced cirrhosis: a positron emission tomography study. Fukuoka Igaku Zasshi 1992, 83:33-42.
112. Burra P, Pizzolato G, Orlando F, et al. Single-photon emission computed tomography with 99mTC-hexamethylpropyleneamineoxide in cirrhotic patients before and after liver transplantation. Transplant Proc 1994, 26:3677-3678.
113. Lockwood AH, Murphy BW, Donnelly KZ, et al. Positron-emission tomographic localization of abnormalities of brain metabolism in patients with minimal hepatic encephalopathy. Hepatology 1993, 18:1061-1068.
114. Lockwood AH, Yap EWH, Wong W-H Cerebral ammonia metabolism in patients with severe liver disease and minimal hepatic encephalopathy. J Cerebr Blood Flow Metab 1991, 11:337-341.
115. Ong JP, Dasarathy S, Aggarwal A, et al. Arterial ammonia levels in hepatic encephalopathy: Usefulness in diagnosis. Advanced hepatic encephalopathy and metabolism in liver disease 2000, 397-402. Ankara University Press, Ankara. C. Yurdaydin, H. Bozkayo (Eds.).
116. Huizerga JR, Tangerman A, Gips CH Determination in biological fluids. Ann Clin Biochem 1996, 33:23-30.
117. van Caulaert C, Deviller C, Hofstein J Epreuve de l'ammoniémie provoqure. Compt Rend Soc Biol 1932, 111:737-788.
118. Kirk E. Amino acid and ammonia metabolism in liver disease. Acta Med Scand 1936, 77(Suppl):1-147.
119. Farquhar JD, Stokes J, Whitlock CM, et al. Studies on the use of aureomycin in hepatic disease. III. A note on aureomycin therapy in hepatic coma. Am J Med Sci 1950, 220:166-172.
120. Sherlock S, Summerskill WHJ, Dawson AM The treatment and prognosis of hepatic coma. Lancet 1956, 2:689-694.
121. Fisher CJ, Faloon WW Blood ammonia levels in hepatic cirrhosis: their control by the oral administration of neomycin. N Engl J Med 1957, 257:1030-1055.
122. Dawson AM, McLaren J, Sherlock S Neomycin in the treatment of hepatic coma?. Lancet 1957, 273:1263-1268.
123. Bircher J, Muller J, Guggenheim P, Hammerli UP Treatment of chronic portal-systemic encephalopathy with lactulose. Lancet 1966, 1:890-892.
124. Strauss E, Tramote R, Silva EP, et al. Double-blind randomized clinical trial comparing neomycin and placebo in the treatment of exogenous hepatic encephalopathy. Hepatogastroenterology 1992, 39:542-545.
125. Blanc P, Daures JP, Liautard J, et al. Lactulose-neomycin combination versus placebo in the treatment of acute hepatic encephalopathy. Results of a randomized controlled trial. Gastroenterol Clin Biol 1994, 18:1063-1068.
126. Orlandi F, Freddara U, Candelaresi MT, et al. Comparison between neomycin and lactulose in 173 patients with hepatic encephalopathy: a randomized clinical study. Dig Dis Sci 1981, 26:498-506.
127. Atterbury CE, Maddrey WC, Conn Ho Neomycin-sorbitol and lactulose in the treatment of acute portal-systemic encephalopathy. A controlled, double-blind clinical trial. Am J Dig Dis 1978, 23:398-406.
128. Conn HO, Leevy CM, Vlacevic ZR, et al. Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. A double-blind controlled trial. Gastroenterology 1977, 72:573-583.
129. Di Piazza S, Gabriella Filippazzo M, Valenza LM, et al. Rifaximin versus neomycin in the treatment of portosystemic encephalopathy. Ital J Gastroenterol 1991, 23:403-407.
130. Parini P, Cippola A, Ponchi M, et al. Effect of rifaximin and paromomycin in the treatment of portal systemic encephalopathy. Curr Ther Res 1992, 52:34-39.
131. Festi D, Mazzella G, Orsini M. Rifaximin in the treatment of chronic hepatic encephalopathy: results of multi-center study of efficacy and safety. Curr Ther Res 1993, 54:598-609.
132. Simmons F, Goldstein H, Boyle JD A controlled clinical trial of lactulose in hepatic encephalopathy. Gastroenterology 1970, 59:827-832.
133. Germain L, Frexinos J, Louis A, Ribet A. A double blind study of lactulose in 18 patients with chronic hepatic encephalopathy after portocaval shunt. Arch Fr Mal App Dig 1973, 62:293-302.
134. Gertman PM, Gagnon O, Iber FL Controlled diarrhea in the treatment of cirrhosis. JAMA 1966, 197:257-260.
135. McClain CJ, Kromhout JP, Zieve L, Duane WC Effect of sorbitol on psychomotor function: its use in alcoholic cirrhosis. Arch Intern Med 1981, 141:901-903.
136. Als-Nielsen B, Gluud LL, Gluud C. Nonabsorbable disaccharides for hepatic encephalopathy (Cochrane Review). The Cochrane Library, Issue 2 2004, John Wiley & Sons, Chichester.
137. Als-Nielsen B, Gluud LL, Gluud C. Non-absorbable disaccharides for hepatic encephalopathy: systemic review of randomized trials. Br Med J 2004, 328:1046.
138. Als-Nielsen B., Gluud LL, Gluud C. Benzodiazepine receptor antagonists for hepatic encephalopathy (Cochrane Review). The Cochrane Library, Issue 2 2004, John Wiley & Sons, Chichester.
139. Als-Nielsen B, Koretz RL, Kjaergard LL, Gluud C. Branched-chain amino acids for hepatic encephalopathy (Cochrane Review). The Cochrane Library, Issue 2 2003, John Wiley & Sons, Chichester.
140. Als-Nielsen B, Gluud LL, Gluud C. Dopaminergic agents for hepatic encephalopathy (Cochrane Review). The Cochrane Library, Issue 4 2004, John Wiley & Sons, Chichester.
141. Liu JP, Gluud LL, Als-Nielsen B, Gluud C. Artificial and bioartificial support systems for liver failure. The Cochrane Library, Issue 1 2004, John Wiley & Sons, Chichester.
142. Kircheis G, Nilius R, Held C, et al. Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology 1997, 25:1351-1360.
143. Kiba T, Numata K, Saito S. Neostigmine and polyethylene glycol solution for the therapy of acute hepatic encephalopathy with liver cirrhosis and ascites. Hepatogastroenterology 2002, 50:823-826.
144. Van Thiel DH, Fagiuoli S, Wright HI, et al. Gastrointestinal transit in cirrhotic patients: Effect of hepatic encephalopathy and its treatment. Hepatology 1994, 17:67-71.
145. Bouin M, Vincent C, Bouhier K, et al. Increased oro-cecal transit time in grade I or II hepatic encephalopathy. Gastroenterol Clin Biol 2000, 28:1240-1244.
146. Nelson DC, McGrew WERG, Holimpa AM Hypernatremia and lactulose therapy. JAMA 1983, 249:1295-1298.
147. Elkington SG, Floch MH, Conn HO Lactulose in the treatment of chronic portal-systemic encephalopathy. A double-blind clinical trial. N Engl J Med 1969, 281:408-412.
148. Rodgers JB, Kiley JE, Balint JA Comparison of results of long-term treatment of chronic hepatic encephalopathy with lactulose and sorbitol. Am J Gastroenterol 1973, 60:459-465.
149. Uribe M, Campollo O, Vargas F, et al. Acidifying enemas (lactitol and lactose) vs. nonacidifying enemas (tap water) to treat acute portal-systemic encephalopathy: a double-blind, randomized clinical trial. Hepatology 1987, 7:639-643.
150. Watanabe A, Sakai T, Sato S, et al. Clinical efficacy of lactulose in cirrhotic patients with and without subclinical hepatic encephalopathy. Hepatology 1997, 26:1410-1414.
151. Shi H, Liu HY, Fu Z, et al. Lactitol in treatment of subclinical hepatic encephalopathy: a double blind placebo-controlled randomized trial (Chinese). Chin J Dig 1997, 17:221-223.
152. Li Z, Zhang H, Hong Y Clinical effect of lactulose in the treatment of subclinical hepatic encephalopathy. Chin J Integr Trad West Med Liver Dis 1999, 9:13-15.
153. Dhiman RK, Sawhney MS, Chawla YK, et al. Efficacy of lactulose in cirrhotic patients with subclinical hepatic encephalopathy. Dig Dis Sci 2000, 45:1549-1552.
154. Russo M, Galanti B, Nardiello S, et al. Ribostamycin for the treatment of hepatic encephalopathy: A crossover study with lactulose. Curr Ther Res Clin Exp 1989, 45:133-141.
155. Orlandi F, Brunelli E, Benedetti A, Macani A. Clinical trials of non-absorbable disaccharide therapy, in hepatic encephalopathy. Hepatic encephalopathy: syndromes and treatment 1994, 209-212. Medi Ed Press, Bloomington IL. H.O. Conn, J. Bircher (Eds.).
156. Uribe M. Management of portal systemic encephalopathy with lactose in patients with lactose deficiency. Hepatic encephalopathy: syndromes and therapies 1994, 311-327. Medi Ed Press, Bloomington, IL. H.O. Conn, J. Bircher (Eds.).
157. Bircher J, Ulrich D. Clinical pharmacology of lactulose, lactitol and related disaccharides. Hepatic encephalopathy: syndrome and therapies 1994, 195-208. Medi Ed Press, Bloomington IL. H.O. Conn, J. Bircher (Eds.).
158. Conn HO, Floch MH Effects of lactulose and Lactobacillus acidophilus on the fecal flora. Am J Clin Nutr 1970, 23:1588-1594.
159. Price JB, Sawoda M, Voorhees AB Clinical significance of intraluminal pH in intestinal ammonia transport. Am J Surg 1970, 119:595-598.
160. Fessel JM, Conn HO Lactulose in the treatment of acute hepatic encephalopathy. Am J Med Sci 1973, 266:103-110.
161. Weber FL The effect of lactulose on urea metabolism and nitrogen excretion in cirrhotic patients. Gastroenterology 1979, 77:118-123.
162. Vince A, Killingsley M, Wrong OM Effect of lactulose on ammonia production in a fecal incubation system. Gastroenterology 1978, 76:544-549.
163. Mortensen PB The effect of orally administered lactulose on colonic nitrogen metabolism and excretion. Hepatology 1992, 16:1350-1356.
164. Van Leeuwen PAM, Van Berlo CL, Soeters PB New mode of action for lactulose. Lancet 1988, 1:55-56.
165. Romero-Gomez M, Ramos-Guerrero R, Grande L, et al. Intestinal glutaminase activity is increased in liver cirrhosis and correlates with minimal hepatic encephalopathy. J Hepatol 2004, 41:49-54.
166. Sanaka MR, Ong JF, Mullen KD Challenges of designing hepatic encephalopathy treatment trials. Hepatology 2003, 38:527-529.
167. Blei AT, Cordoba J Hepatic encephalopathy. Am J Gastroenterol 2001, 96:1968-1976.
168. Silen W, Harper H, Mawdsley Dl, Weirich Wl Effect of antibacterial agents on ammonia production within the intestine. Proc Soc Exp Biol Med 1955, 88:138-140.
169. Dobbins WO, Herrero BA, Mansback CM Morphologic alterations associated with neomycin induced malabsorption. Am J Med Sci 1968, 255:63-77.
170. Jacobson ED, Prior JT, Faloon WW Malabsorptive syndrome induced by neomycin. Morphologic alterations with jejunal mucosa. J Lab Clin Med 1960, 50:245-250.
171. Weber FLJ, Veach GL The importance of the small intestine in gut ammonia production in the fasted dog. Gastroenterology 1979, 77:235-240.
172. Gunnarsdottir SA, Sadik R, Shev S, et al. Small intestinal motility disturbances and bacterial overgrowth in patients with liver cirrhosis and portal hypertension. Am J Gastroenterol 2003, 98:1362-1370.
173. Williams R, Bass N. Rifaximin, a nonabsorbed oral antibiotic, in the treatment of hepatic encephalopathy: antimicrobial activity, efficacy and safety. Rev Gastroenterol Disord 2005, 5(Suppl):10-18.
174. Zeneroli ML, Avallone R, Corsi L, et al. Management of hepatic encephalopathy: role of rifaximin. Chemotherapy 2005, 51(Suppl):90-95.
175. Miglio F, Valpiani D, Rosselini SR, Ferrini A Rifaximin, a nonabsorbable rifaximycin for the treatment of hepatic encephalopathy. A double blind randomized trial. Curr Med Res Opin 1997, 13:593-601.
176. Bucci L, Palmieri GC Double-blind, double-dummy comparison between treatment with rigaximin and lactulose in patients with medium to severe degree hepatic encephalopathy. Curr Med Res Opin 1993, 12:109-118.
177. Fera G, Agostinacchio F, Nigro M, et al. Rifaximin in the treatment of hepatic encephalopathy. Eur J Clin Res 1993, 4:57-66.
178. Massa P, Vallerino E, Dodero M. Treatment of hepatic encephalopathy with rifaximin: double-blind, double dummy study versus lactulose. Eur J Clin Res 1993, 4:7-18.
179. Song H, Lee KS, Kim MH, et al. The clinical efficacy of rifaximin in the treatment of hepatic encephalopathy (comparison with lactulose) [abstract]. Hepatology 2000, 32:407.
180. Loguercio C, Federico A, De Girolamo V, et al. Cyclic treatment of chronic hepatic encephalopathy with rifaximin. Results of a double-blind clinical study. Minerva Gastroenterol Dietol 2003, 49:53-62.
181. Pedretti G, Calzetti C, Missale C, Fiackadon F. Rifaximin versus neomycin on hyperammonemia in chronic portal systemic encephalopathy of cirrhosis: a double-blind randomized trial. Ital J Gastroenterol 1991, 23:175-178.
182. Williams R, James OE, Warners TW, Morgan MY Evaluation of the efficacy and safety of rifaximin in the treatment of hepatic encephalopathy: a double-blind, randomized, dose finding multi-center study. Eur J Gastroenterol Hepatol 2000, 12:203-208.
183. Puxeddu A, Quartini M, Massimetti A, Ferrieri A. Rifaximin in the treatment of chronic hepatic encephalopathy. Curr Med Res Opin 1995, 13:274-281.
184. Mas A, Rodes J, Sunyer L, et al. Comparison of rifaximin and lactitol in the treatment of acute hepatic encephalopathy: results of a randomized, double-blind, double-dummy, controlled clinical trial. J Hepatol 2003, 38:51-58.
185. Morgan M, Read AE, Speller PCE Treatment of hepatic encephalopathy with metronidazole. Gut 1982, 23:1-7.
186. Tarao K, Ikeda T, Hayashi K, et al. Successful use of vancomycin hydrochloride in the treatment of lactulose resistant chronic hepatic encephalopathy. Gut 1990, 31:702-706.
187. Soulsby CT, Morgan MY Dietary management of hepatic encephalopathy in cirrhotic patients: survey of current practice in United Kingdom. Br Med J 1999, 318:1391.
188. Plauth M, Merli M, Kondrup J, et al. ESPEN guidelines for nutrition in liver disease and transplantation (Consensus statement). Clin Nutr 1997, 16:43-55.
189. Plauth M, Merli M, Kondrup J. Management of hepatic encephalopathy. N Engl J Med 1997, 337:1921-1922.
190. Seymour CA, Whelan K Dietary management of hepatic encephalopathy. Br Med J 1999, 318:1364-1365.
191. Cordoba J, Lopez-Hellin J, Planas M, et al. Normal protein diet for episodic hepatic encephalopathy: results of a randomized study. Hepatology 2004, 41:38-43.
192. Erikkson LS, Conn HO Branched-chain amino acids in hepatic encephalopathy. Gastroenterology 1990, 99:604-607.
193. Gluud C. Branched-chain amino acids for hepatic encephalopathy?. Hepatology 1991, 13:812-813.
194. Naylor CD Branched-chain amino acids in hepatic encephalopathy. Continuing controversy (letter; comment). Int J Technol Assess Health Care 1991, 7:648-650.
195. Ferenci P. Branched-chain amino acids in hepatic encephalopathy. Gastroenterology 1990, 98:1395-1396.
196. Erikkson LS, Conn HO Branched-chain amino acids in the management of hepatic encephalopathy an analysis of variants. Hepatology 1989, 10:228-246.
197. Naylor CD, O'Rourke K, Detsky AS, Baker JP Parenteral nutrition with branched-chain amino acids in hepatic encephalopathy. A meta-analysis. Gastroenterology 1989, 97:1033-1042.
198. Shaw S, Worner TM, Lieber CS Comparison of animal and vegetable protein sources in the dietary management of hepatic encephalopathy. Am J Clin Nutr 1983, 38:59-63.
199. Keshavarzian A, Meek J, Sutton C, et al. Dietary protein supplementation from vegetable sources in the management of chronic portal systemic encephalopathy. Am J Gastroenterol 1984, 79:945-949.
200. Uribe M, Dibildox M, Malpica S, et al. Beneficial effect of vegetable protein diet supplemented with psyllium plantago in patients with hepatic encephalopathy and diabetes mellitus. Gastroenterology 1985, 88:901-907.
201. Herman R, Shakoor T, Weber FL Beneficial effect of pectin in chronic hepatic encephalopathy. Gastroenterology 1987, 92:1795.
202. Garcia-Compean D, Uribe M. Fiber rather than protein determines tolerance to nitrogen load in chronic portal systemic encephalopathy: a randomized trial. Hepatology 1987, 7:1034. [abstract].
203. Uribe M, Conn HO Dietary management of portal-systemic encephalopathy. Hepatic encephalopathy: Syndromes and therapy 1994, 331-349. Medi-Ed Press, Bloomington, IL. H.O. Conn, J. Bircher (Eds.).
204. Marchesini G, Dioguardi FS, Bianchi GP, et al. Long-term oral branched-chain amino acid treatment in chronic hepatic encephalopathy. A randomized double-blind casein-controlled trial. The Italian Multicenter Study Group. J Hepatol 1990, 11:92-1001.
205. Egberts EH, Schomerus H, Hamster W, Jurgens P Branched-chain amino acids in the treatment of latent portosystemic encephalopathy. A double blind placebo controlled crossover study. Gastroenterology 1985, 88:887-895.
206. Horst D, Grace ND, Conn HO, et al. Comparison of dietary protein with an oral, branched chain enriched amino acid supplement in chronic portal-systemic encephalopathy. Hepatology 1984, 4:279-287.
207. Uribe M, Moran S, Poo JL, et al. Beneficial effect of carbohydrate maldigestion induced by a disaccharidase in inhibitor (AO-128) in the treatment of chronic portal-systemic encephalopathy. A double-blind randomized controlled trial. Scand J Gastroenterol 1998, 33:1099-1106.
208. Solga SF Probiotics can treat hepatic encephalopathy. Med Hypoth 2003, 61:307-313.
209. Bongaerts G, Severijinam R, Timmerman H. Effect of antibiotics, prebiotics and probiotics in treatment for hepatic encephalopathy. Med Hypoth 2005, 64:64-68.
210. Jic L, Zhang MH Comparison of probiotics and lactulose in the treatment of hepatic encephalopathy in rats. World J Gastroenterol 2005, 14:908-914.
211. Liu Q, Duan ZP, Ha da K, et al. Symbiotic modulation of gut flora on minimal hepatic encephalopathy in patients with cirrhosis. Hepatology 2004, 39:1441-1449.
212. Solga SF, Diehl AM Gut flora based therapy in liver disease? The liver cares about the gut. Hepatology 2004, 39:199-200.
213. Macbeth WA, Kass EH, McDermott WV Treatment of hepatic encephalopathy by alteration of intestinal flora with lactobacillus acidophilus. Lancet 1965, 1:399-403.
214. Reed AE, McCarthy CF, Heaton KW, Laidlaw J Lactobacillus acidophilus in treatment of hepatic encephalopathy. Br Med J 1966, 1:1267-1269.
215. Loguerico C, Del Vecchio Blanco C, Coltarti M Enterococcus lactic acid bacterial strain SF 68 and lactulose in hepatic encephalopathy: A controlled trial. J Int Med Res 1987, 15:335-343.
216. Loguerico C, Abbiati R, Ranaldi M, et al. Long-term efficacy of enterococcus fecium SF 68 versus lactulose in the treatment of patients with cirrhosis. J Hepatol 1995, 23:39-46.
217. Kircheis G, Quack G, Erbler H. L-ornithine-L-aspartate in the treatment of hyperammonemia and hepatic encephalopathy. Hepatic encephalopathy: Syndromes and therapies 1994, 373-383. Medi-Ed Press, Bloomington, IL. H.O. Conn, J. Bircher (Eds.).
218. Kircheis G, Wettstein M, Dahl S, Haussinger D. Clinical efficacy of L-ornithine-L-aspartate in the management of hepatic encephalopathy. Metab Brain Dis 2002, 17:453-462.
219. Stauch S, Kircheis G, Adler F, et al. Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy: results of a placebo-controlled double-blind study. J Hepatol 1998, 28:856-864.
220. Delcker AM, Jalan R, Schumacher M, Comes G L-Ornithine-L-aspartate vs placebo in the treatment of hepatic encephalopathy: a meta-analysis of randomized placebo-controlled trials using individual data. Hepatology 2000, 32:310A. [abstract].
221. Mendenhall CL, Rouster S, Marshall L, Weisner R A new therapy for portal systemic encephalopathy. Am J Gastroenterol 1986, 82:540-543.
222. Sushma S, Dasarathy S, Tandon RK, et al. Sodium benzoate in the treatment of acute encephalopathy: a double blind randomized trial. Hepatology 1982, 16:138-144.
223. Mullen KD, Martin JV, Mendelson WB, et al. Evidence for the presence of benzodiazepines receptor binding substances in cerebrospinal fluid of a rabbit model of hepatic encephalopathy. Metab Brain Dis 1989, 4:253-260.
224. Basile AS, Parnell L, Jasuri T, et al. Brain concentrations of benzodiazepines are elevated in an animal model of hepatic encephalopathy. Proc Natl Acad Sci USA 1990, 87:5263-5267.
225. Mullen KD, Szauter KM, Kaminsky Russ K. Endogenous benzodiazepine activity in physiological fluids of patients with hepatic encephalopathy. Lancet 1990, 336:81-83.
226. Basile AS, Hughes RD, Harrison PM, et al. Elevated brain concentrations of 1:4-benzodiazepines in fulminant hepatic failure. N Engl J Med 1991, 325:473-478.
227. Yurdaydin C, Li Y, Ha JH, et al. Brain and plasma levels of opioid peptides are altered in rats with thioacetamide-induced liver failure: implications for the treatment of hepatic encephalopathy. J Pharmacol Exp Ther 1995, 273:185-192.
228. Yurdaydin C, Karavelioglu D, Onaran O, et al. Opioid receptor ligands in human hepatic encephalopathy. J Hepatol 1999, 29:796-801.
229. Reding P, Duchateau J, Bataile C. Oral zinc supplements improve hepatic encephalopathy. Results of a randomized controlled trial. Lancet 1984, 2:493-495.
230. Riggio O, Oriosto F, Merli M, et al. Short-term oral zinc supplementation does not improve chronic hepatic encephalopathy: results of a double-blind crossover trial. Dig Dis Sci 1991, 36:1204-1208.
231. Riggio O, Merli M, Capocaccia L, et al. Zinc supplementation reduces blood ammonia and increased liver transcarbamylase activity in experimental cirrhosis. Hepatology 1992, 16:785-788.
232. Keeling PW, Jones RB, Hilton PJ, Thompson RH Reduced leucocyte zinc in liver disease. Gut 1980, 21:561-564.
233. Van der Rijt CCD, Scholm SW, Wchat H, et al. Overt hepatic encephalopathy precipitated by zinc deficiency. Gastroenterology 1991, 100:1114-1118.
234. Mullen KD, Dasarathy S MARS - Does it stand the test of time?. Metab Brain Dis 2004, 19:223-228.
235. Mitzner SR, Klammt S, Peszynski P, et al. Improvement of multiple organ functions in hepatorenal syndrome during albumin dialysis with the molecular adsorbent recirculating system. Ther Apher 2001, 5:417-422.
236. O'Grady JG, Gimson AE, O'Brien CJ, et al. Controlled trials of charcoal hemoperfusion and prognostic factors in fulminant hepatic failure. Gastroenterology 1988, 94:1186-1192.
237. Hughes RD, Pucknell A, Routley D, et al. Evaluation of the Biologic-DT sorbent-suspension dialyser in patients with fulminant hepatic failure. Int J Artif Org 2001, 24:434-442.
238. Ellis AJ, Hughes RD, Nicholl D, et al. Temporary extracorporeal liver support for severe acute alcoholic hepatitis using the BioLogic-DT. Int J Artif Org 1999, 22:27-34.
239. Wilkinson AH, Ash SR, Nissenson AR Hemodiabsorption in treatment of hepatic failure. J Transpl Coord 1998, 8:43-50.
240. He JQ, Chen CY, Deng JTT, et al. Clinical study on the treatment of fatal hepatitis with artificial liver support system. Chin Crit Care Med 2000, 12:105-108.
241. Ellis AJ, Hughes RD, Wendon JA, et al. Pilot-controlled trial of the extracorporeal liver assist device in acute liver failure. Hepatology 1996, 24:1446-1451.
242. Stevens C, Busuttil R, Han S, et al. An interim analysis of a phase II/III prospective randomized multicenter controlled trial of the Hepat Assist Bioartificial Liver Support System for the treatment of fulminant hepatic failure. Hepatology 2001, 4. [abstract].
243. Mitzner SR, Stange J, Klammt S, et al. Improvement of hepatorenal syndrome with extracorporeal albumin dialysis MARS: results of a prospective, randomized, controlled clinical trial. Liver Transpl 2000, 6:287-289.
244. Kramer L, Gendo A, Madl C, et al. A controlled study of sorbent suspension dialysis in chronic liver disease and hepatic encephalopathy. Int J Artif Org 2001, 24:434-442.
245. Sen S, Jalan R, Williams R. Extracorporeal albumin dialysis in acute-on-chronic liver failure: will it stand the test of time?. Hepatology 2002, 36:1014-1016.
246. Liu JP, Gluud LL, Als-Nielsen B, Gluud C. Artificial and bioartificial support systems for liver failure. The Cochrane Library, Issue 1 2004, John Wiley & Sons, Chichester.
247. Kjaergard LL, Liu J, Als-Nielsen B, Gluud C. Artificial and bioartificial support systems for acute and acute-on-chronic liver failure: a systematic review. JAMA 2003, 289:217-222.
248. Clarke B, Ellis MJ, Leung V, et al. Reversal of hepatic encephalopathy and alteration in amino acid profiles after blocking a surgical splenorenal shunt by interventional radiological techniques. J Hepatol 1989, 8:325-329.
249. Hiroka A, Kubose K, Hamada M. Hepatic encephalopathy due to intrahepatic portosystemic venous shunt successfully treated by interventional radiology. Intern Med 2004, 44:212-216.
250. Sachdev A, Duseja A. Decompressive shunts and hepatic encephalopathy. Indian J Gastroenterol 2003, 22(Suppl 2):S21-S24.
251. Ong JP, Mullen KD Hepatic encephalopathy. Eur J Gastroenterol Hepatol 2001, 13:325-334.
252. Gerbes AL, Waggershauser T, Holl J, et al. Experiences with novel techniques for reduction of start flow in transjugular intrahepatic portosystemic shunts. Z Gastroenterol 1998, 36:373-377.
253. Rossle M, Siegerstetter V, Huber M, Ochs A. The first decade of the transjugular intrahepatic portosystemic shunt (TIPS): State of the art. Liver 1998, 1:73-89.
254. Nishie A, Yoshimitsu K, Honda H. Treatment of hepatic encephalopathy by retrograde and transcaval coil embolization of an ilea vein-to-right gonadal vein portosystemic shunt Cardiovasc. Intervent Radiol 1997, 20:222-224.
255. Mullen KD Hepatic encephalopathy after portosystemic shunts: Any clues from TIPS. Am J Gasterol 1995, 70:531-533.