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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)

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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Correspondence to Markus Peck-Radosavljevic MD.

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For the Austrian Society of Gastroenterology and Hepatology (ÖGGH)

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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Keywords

  • Ascites
  • Variceal bleeding
  • TIPS
  • Hepatorenal syndrome
  • Hepatopulmonary syndrome
  • Portopulmonary hypertension
  • Budd-Chiari Syndrome
  • Somatostatin
  • Terlipressin
  • Carvedilo

Schlüsselwörter

  • Aszites
  • Varizenblutung
  • TIPS
  • Hepatorenales Syndrom
  • Hepatopulmonales Syndrom
  • Portopulmonale Hypertension
  • Budd-Chiari Syndrom
  • Somatostatin
  • Terlipressin
  • Carvedilol