First Latin American consensus on the treatment and prophylaxis of hepatic encephalopathy

Higuera-de-la-Tijera F.; Alvares-da-Silva M.R.; Castro-Narro G.E.; Barahona-Garrido J.; Carrera-Estupiñán E.; Garavito-Rentería J.; Henríquez-Meléndez H.A.; Hernández-Cely G.; Mora-Lazo J.; Mendizabal M.; Mezzano-Puentes G.A.; Oliveira C.P.; Guimarães Pessoa M.; Suárez-Quintero Y.; Velarde-Ruiz Velasco J.A. · Annals of Hepatology (2026) · DOI: 10.1016/j.aohep.2025.102142

Resumen

Introduction and Objectives Hepatic encephalopathy (HE) is a frequent and severe complication of cirrhosis, leading to rapid deterioration and increased mortality. Management varies across Latin America due to differences in disease awareness, diagnostic and therapeutic resources, and healthcare system structures. Standardized guidelines are crucial to improve outcomes. Materials and Methods To evaluate therapeutic strategies and develop region-specific recommendations, the Latin American Association for the Study of the Liver (ALEH) convened 15 experts from 9 countries. The consensus process, conducted in 9 phases using the Nominal Group Technique, included virtual meetings, platform-based collaboration, virtual voting, and two in-person sessions to finalize recommendations and the publication draft. Results The panel issued 23 recommendations covering the treatment of minimal and overt HE, as well as the prophylaxis and management of recurrent HE in cirrhotic patients. Conclusions This consensus provides updated, evidence-based guidelines emphasizing early diagnosis and effective management. It aims to optimize clinical outcomes, standardize treatment approaches, and enhance patient quality of life. Additionally, these recommendations seek to reduce morbidity, mortality, and hospital readmissions, addressing key challenges in the Latin American healthcare landscape.