Limited resection of pancreatic cancer in high-risk patients can result in a second primary: Table 1

15%) had abdominal bloating in Gp-L, while 3 (5%) patients experienced abdominal pain and nausea in rifaximin, but no patient was withdrawn from the trial due to these adverse effects.Baseline MELD score, Child-Turcotte-Pugh score, bilirubin, arterial ammonia, heart rate, mean arterial pressure and total leucocyte count significantly correlated with development of HE.On multivariate analysis, only baseline arterial ammonia and blood transfusion requirement during hospital stay were the predictors of development of HE (table 3).The results of two recently published meta-analyses which compared the efficacy of oral non-absorbable disaccharides versus rifaximin in the management HE showed that both lactulose and rifaximin are equally effective and rifaximin is better tolerated.6 7 In our study, rifaximin was not superior to lactulose for prophylaxis of HE in patients of cirrhosis with AVB and well tolerated.It will be worthwhile to give rifaximin or lactulose as a standard treatment in the management of AVB in patients with cirrhosis to prevent HE considering the prognosis, burden and associated cost in the management of HE.