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Aim To determine the efficacy and safety of probiotics vs.lactulose for the management of Minimal hepatic encephalopathy (MHE).Methods MEDLINE, EMBASE, PUBMED, WEB OF SCIENCE, CNKI Database, VIP database and the Cochrane Database of Systematic Reviews were searched for published studies in all languages.Inclusion and exclusion criteria were defined prior.Pooled relative risk and heterogeneity were estimated as the measures of association.