The diagnosis and management of portal hypertension in cirrhosis: The Gastroenterological Society of Australia consensus.
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Majumdar Avik, Holmes Jacinta, Roberts Stuart K, Bhat Purnima, Mitchell Tim, Ramachandran Jeyamani, O'Beirne James, Walker Sarah, Sawhney Rohit, Jagarlamudi Nishita, Jacob Rachael, Gill Madeleine, Thomas James A, Bloom Stephen, Gracen Lucy, Kemp William, Raj Ashok, Thompson Alexander J, Romero Sarah, Doyle Adam, Maher Adrian, Pow Richard, Robertson Marcus, Tiwari Neha, Tibballs Jonathan, Lubel John, Popuri Radha, Testro Adam, Valliani Talal, Waller Karen, Chapman Brooke, Gupta Rohit, Hey Penelope, Keating Shelley, Sinclair Marie, Janko Natasha, Koshy Anoop, Majeed Ammar, Mohammadi Fadak, Fergusson James, Furtado Ruelan, MacQuillan Gerry, Muller Kate, Santhakumar Cositha, Ahlenstiel Golo, Strasser Simone I
Аннотация
METHODS: The consensus statement was developed in accordance with the Appraisal of Guidelines for Research and Evaluation II instrument and the 2016 National Health and Medical Research Council Standards for Guidelines. A panel of 46 health care professionals with expertise in managing portal hypertension participated in the development of the consensus statement. The consensus development conference method was used to determine consensus for each recommendation, with a hybrid face-to-face and online meeting held in Noosa, Australia, on 3 August 2024, followed by 2 online meetings.
RESULTS: A total of 52 recommendations were approved by the consensus development group without dissent across the following domains: (1) diagnosis, risk stratification, and prevention of decompensation; (2) portal hypertension-related bleeding; (3) ascites and renal impairment; (4) hepatic encephalopathy; (5) sarcopenia, nutrition, and frailty; (6) thrombosis in cirrhosis; (7) cardiopulmonary complications; (8) surgery and portal hypertension; and (9) pregnancy and portal hypertension.
DISCUSSION: This is the first Australian consensus statement on the diagnosis and management of portal hypertension in patients with cirrhosis. The recommendations in this summary document provide standardized clinical guidance with the goal of improving outcomes for patients with cirrhosis and portal hypertension in Australia.