Austrian consensus guidelines on the management and treatment of portal hypertension (Billroth III)

Thomas Reiberger, Andreas Püspök, Maria Schoder, Franziska Baumann-Durchschein, Theresa Bucsics, Christian Datz, Werner Dolak, Arnulf Ferlitsch, Armin Finkenstedt, Ivo Graziadei, Stephanie Hametner, Franz Karnel, Elisabeth Krones, Andreas Maieron, Mattias Mandorfer, Markus Peck-Radosavljevic, Florian Rainer, Philipp Schwabl, Vanessa Stadlbauer, Rudolf Stauber, Herbert Tilg, Michael Trauner, Heinz Zoller, Rainer Schöfl, Peter Fickert, Thomas Reiberger, Andreas Püspök, Maria Schoder, Franziska Baumann-Durchschein, Theresa Bucsics, Christian Datz, Werner Dolak, Arnulf Ferlitsch, Armin Finkenstedt, Ivo Graziadei, Stephanie Hametner, Franz Karnel, Elisabeth Krones, Andreas Maieron, Mattias Mandorfer, Markus Peck-Radosavljevic, Florian Rainer, Philipp Schwabl, Vanessa Stadlbauer, Rudolf Stauber, Herbert Tilg, Michael Trauner, Heinz Zoller, Rainer Schöfl, Peter Fickert

Abstract

The Billroth III guidelines were developed during a consensus meeting of the Austrian Society of Gastroenterology and Hepatology (ÖGGH) and the Austrian Society of Interventional Radiology (ÖGIR) held on 18 February 2017 in Vienna. Based on international guidelines and considering recent landmark studies, the Billroth III recommendations aim to help physicians in guiding diagnostic and therapeutic strategies in patients with portal hypertension.

Keywords: Ascites; Austria; Billroth; Cirrhosis; Guidelines; Portal hypertension; TIPS; Varices.

Conflict of interest statement

T. Reiberger, A. Püspök, M. Schoder, F. Baumann-Durchschein, T. Bucsics, C. Datz, W. Dolak, A. Ferlitsch, A. Finkenstedt, I. Graziadei, S. Hametner, F. Karnel, E. Krones, A. Maieron, M. Mandorfer, M. Peck-Radosavljevic, F. Rainer, P. Schwabl, V. Stadlbauer, R. Stauber, H. Tilg, M. Trauner, H. Zoller, R. Schöfl, and P. Fickert declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart for screening of varices in cirrhotic patients. TE transient elastography, PLT platelet count, GOV gastroesophageal varices
Fig. 2
Fig. 2
Flow chart for treatment of acute variceal bleeding. EV esophageal varices, EVL endoscopic variceal ligation, TIPS transjugular portosystemic shunt, i.v. intravenous
Fig. 3
Fig. 3
Flow chart for portal hypertensive gastropathy (PHG) and gastric antral vascular ectasia (GAVE). APC argon plasma coagulation, GAVE gastric antral vascular ectasia, NSBBs non-selective beta blockers, PHG portal hypertensive gastropathy, TIPS transjugular intrahepatic portosystemic shunt
Fig. 4
Fig. 4
Management of AKI in cirrhosis. Adapted from [133] (AKI acute kidney injury, ICA International Club of Ascites, HPF high power field, HRS hepatorenal syndrome, NSAIDs non-steroidal anti-inflammatory drugs, NSBBs non-selective beta blockers, RBCs red blood cells, RRT renal replacement therapy, SBP spontaneous bacterial peritonitis, sCr serum creatinine)

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