Austrian consensus on the diagnosis and management of portal hypertension in advanced chronic liver disease (Billroth IV)

Mattias Mandorfer; Elmar Aigner; Manfred Cejna; Arnulf Ferlitsch; Christian Datz; Tilmann Gräter; Ivo Graziadei; Michael Gschwantler; Stephanie Hametner-Schreil; Harald Hofer; Mathias Jachs; Alexander Loizides; Andreas Maieron; Markus Peck-Radosavljevic; Florian Rainer; Bernhard Scheiner; Georg Semmler; Lukas Reider; Silvia Reiter; Maria Schoder; Rainer Schöfl; Philipp Schwabl; Vanessa Stadlbauer; Rudolf Stauber; Elisabeth Tatscher; Michael Trauner; Alexander Ziachehabi; Heinz Zoller; Peter Fickert; Thomas Reiberger

doi:10.1007/s00508-023-02229-w

Austrian consensus on the diagnosis and management of portal hypertension in advanced chronic liver disease (Billroth IV)

Wien Klin Wochenschr. 2023 Sep;135(Suppl 3):493-523. doi: 10.1007/s00508-023-02229-w. Epub 2023 Jun 26.

Authors

Mattias Mandorfer^{1

2}, Elmar Aigner³, Manfred Cejna⁴, Arnulf Ferlitsch⁵, Christian Datz⁶, Tilmann Gräter⁷, Ivo Graziadei⁸, Michael Gschwantler⁹, Stephanie Hametner-Schreil¹⁰, Harald Hofer¹¹, Mathias Jachs^{12

13}, Alexander Loizides¹⁴, Andreas Maieron¹⁵, Markus Peck-Radosavljevic¹⁶, Florian Rainer¹⁷, Bernhard Scheiner^{12

13}, Georg Semmler^{12

13}, Lukas Reider¹⁸, Silvia Reiter¹⁹, Maria Schoder¹⁸, Rainer Schöfl¹⁰, Philipp Schwabl^{12

13}, Vanessa Stadlbauer¹⁷, Rudolf Stauber¹⁷, Elisabeth Tatscher¹⁷, Michael Trauner¹², Alexander Ziachehabi¹⁹, Heinz Zoller²⁰, Peter Fickert¹⁷, Thomas Reiberger^{21

22}

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. mattias.mandorfer@meduniwien.ac.at.
² Vienna Hepatic Hemodynamic Laboratory, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. mattias.mandorfer@meduniwien.ac.at.
³ First Department of Medicine, Paracelsus Medical University, Salzburg, Austria.
⁴ Department of Radiology, LKH Feldkirch, Feldkirch, Austria.
⁵ Department of Internal Medicine I, KH Barmherzige Brüder Wien, Vienna, Austria.
⁶ Department of Internal Medicine, General Hospital Oberndorf, Teaching Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria.
⁷ Department of Radiology, Medical University of Graz, Graz, Austria.
⁸ Department of Internal Medicine, KH Hall in Tirol, Hall, Austria.
⁹ Division of Gastroenterology and Hepatology, Department of Medicine IV, Klinik Ottakring, Vienna, Austria.
¹⁰ Department of Gastroenterology and Hepatology, Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria.
¹¹ Department of Internal Medicine I, Klinikum Wels-Grieskirchen, Wels, Austria.
¹² Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
¹³ Vienna Hepatic Hemodynamic Laboratory, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
¹⁴ Department of Radiology, Medical University of Innbsruck, Innsbruck, Austria.
¹⁵ Department of Internal Medicine II, University Hospital St. Pölten, St. Pölten, Austria.
¹⁶ Department of Internal Medicine and Gastroenterology, Hepatology, Endocrinology, Rheumatology and Nephrology, Klinikum Klagenfurt am Wörthersee, Klagenfurt, Austria.
¹⁷ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
¹⁸ Department of Interventional Radiology, Medical University of Vienna, Vienna, Austria.
¹⁹ Department of Internal Medicine and Gastroenterology and Hepatology, Kepler Universitätsklinikum, Linz, Austria.
²⁰ Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria.
²¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. thomas.reiberger@meduniwien.ac.at.
²² Vienna Hepatic Hemodynamic Laboratory, Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. thomas.reiberger@meduniwien.ac.at.

Abstract

The Billroth IV consensus was developed during a consensus meeting of the Austrian Society of Gastroenterology and Hepatology (ÖGGH) and the Austrian Society of Interventional Radiology (ÖGIR) held on the 26th of November 2022 in Vienna.Based on international recommendations and considering recent landmark studies, the Billroth IV consensus provides guidance regarding the diagnosis and management of portal hypertension in advanced chronic liver disease.

Keywords: Acute-on-chronic liver failure; Ascites; Cirrhosis; Elastography; HVPG; Hepatorenal syndrome; Portal vein thrombosis; Spontaneous bacterial peritonitis; Transjugular intrahepatic portosystemic shunt; Variceal bleeding; Varices.

MeSH terms

Austria
Consensus
Esophageal and Gastric Varices*
Gastrointestinal Hemorrhage
Humans
Hypertension, Portal* / complications
Hypertension, Portal* / diagnosis
Hypertension, Portal* / therapy
Liver Cirrhosis