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Austrian consensus on the definition and treatment of portal hypertension and its complications (Billroth II)

Österreichischer Konsensus zur Definition und Therapie der Portalen Hypertension und ihrer Komplikationen (Billroth II)

  • consensus report
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Summary

In November 2004, the Austrian Society of Gastroenterology and Hepatology (ÖGGH) held for the first time a consensus meeting on the definitions and treatment of portal hypertension and its complications in the Billroth-Haus in Vienna, Austria (Billroth I-Meeting). This meeting was preceded by a meeting of international experts on portal hypertension with some of the proponents of the Baveno consensus conferences (http://www.oeggh.at/videos.asp). The consensus itself is based on the Baveno III consensus with regard to portal hypertensive bleeding and the suggestions of the International Ascites Club regarding the treatment of ascites. Those statements were modified by new knowledge derived from the recent literature and also by the current practice of medicine as agreed upon by the participants of the consensus meeting. In October 2011, the ÖGGH organized the second consensus meeting on portal hypertension and its complications in Vienna (Billroth II-Meeting). The Billroth II-Guidelines on the definitions and treatment of portal hypertension and its complications take into account the developments of the last 7 years, including the Baveno-V update and several key publications.

Zusammenfassung

Im November 2004 hielt die Österreichische Gesellschaft für Gastroenterologie und Hepatologie (ÖGGH) den ersten Konsensus über die Definitionen und die Therapie der Portalen Hypertension und ihrer Komplikationen im Billroth-Haus in Wien, Österreich ab (Billroth I Meeting). Diesem Treffen ging ein internationales Expertenmeeting über die Portale Hypertension mit einigen wichtigen Proponenten der Baveno Konsensus-Konferenzen vorraus (http://www.oeggh.at/videos.asp). Der Konsensus selber basiert auf dem Baveno III Konsensus im Hinblick auf die portal-hypertensive Blutung und den Vorschlägen des International Ascites Club in Hinblick auf die Therapie des Aszites. Deren Aussagen wurden mit neuen Erkenntnissen aus der rezenten Literatur und auch entsprechend der praktischen Erfahrung der Teilnehmer des Konsensus-Treffens modifiziert. Im Oktober 2001 organisierte die ÖGGH das zweite Konsensus Treffen über die portale Hypertension und ihrer Komplikationen (Billroth II Meeting). Die Billroth II Leitlinien über die Definitionen und die Therapie der Portalen Hypertension und ihrer Komplikationen lassen die Entwicklungen der letzten 7 Jahre inklusive des Baveno V Updates und etlicher Schlüsselpublikationen mit einfließen und stellen den neuen Standard im Management der Portalen Hypertension in Österreich dar.

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Fig. 1

Abbreviations

AVB:

Acute variceal bleeding

BCS:

Budd-Chiari syndrome

CSPH:

Clinically significant portal hypertension

FCB:

Failure to control bleeding

FFP:

Fresh frozen plasma

GAVE:

Gastric antral vascular ectasia

GOV:

Gastro oesophageal varices

HCC:

Hepatocellular carcinoma

HE:

Hepatic encephalopathy

HPS:

Hepatopulmonary syndrome

HRS:

Hepatorenal syndrome

HVPG:

Hepatovenous pressure gradient

IGV:

Isolated gastric varices

ISMN:

Isosorbidmononitrate

NSBB:

Nonselective beta-blockers

PPHTN:

Portopulmonary hypertension

PTFE:

Polytetrafluoroethylene

PHG:

Portal hypertensive gastropathy

TIPS:

Transjugular intrahepatic portosystemic stent

SBP:

Spontaneous bacterial peritonitis

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Conflict of interest

A. Ferlitsch: Consultant for Pejcl Medizintechnik, Austria; Boston Scientifc: Travel expenses; Boston Scientific, Cook Medical, Ferring: Sponsoring of dedicated meetings.

V. Fuhrmann: Forschungsunterstützung von den Firmen Actelion, Air Liquide und Vivisol.

T. Reiberger: Roche (speaking/teaching, travel grant), MSD (speaking/teaching, research grant), Phenex Pharma (research grant), Gilead Sciences (research grant, travel grant), Janssen (research grant).

Rest of the authors declare that there are no actual or potential conflicts of interest in relation to this article.

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Authors and Affiliations

  1. Klinische Abteilung für Gastroenterologie und Hepatologie, Universitätsklinik für Innere Medizin III, Medizinische Universität Wien, Währinger Gürtel 18–20, 1090, Vienna, Austria

    Markus Peck-Radosavljevic MD, Arnulf Ferlitsch MD, Monika Ferlitsch MD, Valentin Fuhrmann MD, Berit Payer MD, Thomas Reiberger MD & Michael Trauner MD

  2. 2. Medizinische Abteilung, Landesklinikum St. Pölten, St. Pölten, Austria

    Bernhard Angermayr MD

  3. Abteilung Innere Medizin, Krankenhaus Oberndorf, bei Salzburg, Austria

    Christian Datz MD

  4. Krankenhaus St. Elisabeth, Vienna, Austria

    Michael Häfner MD

  5. 1. Medizinische Abteilung mit Gastroenterologie, Krankenhaus Hietzing, Vienna, Austria

    Ludwig Kramer MD & Gregor Ulbrich MD

  6. 4. Interne Abteilung, Krankenhaus St. Elisabeth, Linz, Austria

    Andreas Maieron MD

  7. Klinische Abteilung für Abteilung Gastroenterologie und Hepatologie, Medizinische Universität Graz, Graz, Austria

    Rudolf Stauber MD

  8. Universitätsklinik für Chirurgie, Medizinische Universität Wien, Vienna, Austria

    Rudolf Steininger MD

  9. Klinische Abteilung für Radiologie und Nuklearmedizin, Krankenhaus Barmherzige Brüder Wien, Vienna, Austria

    Siegfried Thurnher MD

  10. Universitätsklinik für Innere Medizin (Gastroenterologie und Hepatologie), Medizinische Universität Innsbruck, Innsbruck, Austria

    Wolfgang Vogel MD, Heinz Zoller MD & Ivo Graziadei MD

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  1. Markus Peck-Radosavljevic MD
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  2. Bernhard Angermayr MD
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  3. Christian Datz MD
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  4. Arnulf Ferlitsch MD
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for the Austrian Society of Gastroenterology and Hepatology (ÖGGH)

Corresponding author

Correspondence to Markus Peck-Radosavljevic MD.

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Appendix

Appendix

Participants “Billroth II”, 2. ÖGGH-Consensus Conference “Portal Hypertension”, Palais Clam Gallas, Vienna 011011

Dr. Bernhard Angermayr

Landesklinikum St. Pölten, 2. Medizinische Abteilung

Dr. Eva Brownstone

KA Rudolfstiftung, 4. Medizinische Abteilung

Theresa Bucsics

Univ.-Klinik für Innere Medizin III, AKH

Prim. Dr. Christian Datz

Krankenhaus Oberndorf, Abteilung Innere Medizin

Dr. Arnulf Ferlitsch

Univ.-Klinik für Innere Medizin III, AKH

PD Dr. Valentin Fuhrmann

Univ.-Klinik für Innere Medizin III, AKH

Univ.-Prof. Dr. Ivo Graziadei

Klinische Abteilung für Gastroenterologie und Hepatologie, Medizinische Universität Innsbruck

Dr. Evelyn Grilnberger

Otto Wagner Spital

Prim. Dr. Michael Häfner

KH St. Elisabeth, Interne Abteilung

Dr. Birgit Heinisch

Univ.-Klinik für Innere Medizin III, AKH

Dr. Sadia Hoppe

KH Hietzing, I. Medizinische Abteilung

Dr. Thomas Horvatits

Univ.-Klinik für Innere Medizin III, AKH

Prim. Dr. Andreas Kirchgatterer

V. Interne Abteilung, Klinikum Wels

Prim. Dr. Peter Knoflach

Klinikum Wels-Grieskirchen, Abteilung für Innere Medizin I

Dr. Andreas Kopecky

Thermenklinikum Baden, Interne Abteilung

Dr. Peter Kotlan

Ordination Markt Priestling

Prof. Dr. Ludwig Kramer

Krankenhaus Hietzing, 1. Medizinische Abteilung mit Gastroenterologie

Dr. Anna Kreil

Otto Wagner Spital

Waltraud Leiss

Univ.-Klinik für Innere Medizin III, AKH

Dr. Simone Luszczak

Landesklinikum St. Pölten, 2. Medizinische Abteilung

Prim. Dr. Christian Madl

KA Rudolfstiftung, 4. Medizinische Abteilung

Dr. Andreas Maieron

Krankenhaus St. Elisabeth Linz, 4. Interne Abteilung

Dr. Ilona Marszalek

Ordination Dr. Biowski-Frotz, Wien

Prof. Dr. Christian Müller

Univ.-Klinik für Innere Medizin III, AKH

Dr. Roland Nömeyer

Klinikum Wels-Grieskirchen, Abteilung für Innere Medizin I

Dr. Julia Palkovits

Krankenhaus Hietzing, 1. Medizinische Abteilung mit Gastroenterologie

Dr. Berit Anna Payer

Univ.-Klinik für Innere Medizin III, AKH

Prof. Dr. Markus Peck-Radosavljevic

Univ.-Klinik für Innere Medizin III, AKH

Prim. Dr. Johann Pidlich

Thermenklinikum Baden, Interne Abteilung

Dr. Csilla Putz-Bankuti

Universitätsklinik für Innere Medizin, LKH Graz

Dr. Thomas Reiberger

Univ.-Klinik für Innere Medizin III, AKH

Dr. Birgit Reinhart

 

Dr. Karoline Reinhart

Univ.-Klinik für Innere Medizin III, AKH

Dr. Petra Salzl

Univ.-Klinik für Innere Medizin III, AKH

Dr. Monika Schmid

Univ.-Klinik für Innere Medizin III, AKH

Dr. Christiane Schrutka

KA Rudolfstiftung, 4. Medizinische Abteilung

Dr. Bernhard Stadler

Klinikum Wels-Grieskirchen

Prof. Dr. Rudolf Stauber

Medizinische Universität Graz, Abteilung Gastroenterologie und Hepatologie

Dr. Philipp Steininger

Krankenhaus St. Elisabeth Wien, Interne Abteilung

Prof. Dr. Rudolf Steininger

Universitätsklinik für Chirurgie, Medizinische Uni Wien

Prim. Dr. Siegfried Thurnher

Krankenhaus Barmherzige Brüder Wien, Radiologie und Nuklearmedizin

Prof. Dr. Michael Trauner

Univ.-Klinik für Innere Medizin III, AKH

Prof. Dr. Barbara Tribl

Univ.-Klinik für Innere Medizin III, AKH

Dr. Gregor Ulbrich

Krankenhaus Hietzing, 1. Medizinische Abteilung mit Gastroenterologie

Prim. Prof. Dr. Wolfgang Vogel

Klinische Abteilung für Gastroenterologie und Hepatologie, Medizinische Universität Innsbruck

Dr. Martina Wichlas

KH Barmherzige Brüder, II. Medizinische Abteilung

Dr. Afrodite Zendeli

KH Barmherzige Brüder, II. Medizinische Abteilung

Prof. Dr. Heinz Zoller

Klinische Abteilung für Gastroenterologie und Hepatologie, Medizinische Universität Innsbruck

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Peck-Radosavljevic, M., Angermayr, B., Datz, C. et al. Austrian consensus on the definition and treatment of portal hypertension and its complications (Billroth II). Wien Klin Wochenschr 125, 200–219 (2013). https://doi.org/10.1007/s00508-013-0337-z

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