Preventive approaches in chronic liver diseases part II: Compensated liver cirrhosis

The objective of this article is to provide evidence-based strategies to prevent or detect early complications of liver cirrhosis (LC). The clinical severity of LC should be assessed once the diagnosis has been made by the scoring systems described. Due to increased risk of perioperative complications or death, patients with LC should undergo elective surgery after careful consideration. Patients diagnosed with LC should undergo esophagogastroduodenoscopy screening to detect varices. Beta-blockers are the first choice for treating patients with esophageal varices to prevent bleeding. In patients not tolerating beta blockers, banding ligation is a valid option. Liver cancer screening with abdominal CT or US at least yearly and serum alpha-feto protein levels every six months is recommended. Other preventive measures like pneumoccocus vaccination, yearly influenza vaccine and osteoporosis screening should be considered in patients with LC. This manuscript is the second part of three articles dealing with preventive measures for liver disease.