Chronic Liver Disease
Cirrhosis or advanced fibrosis
All Pathways
Hepatobiliary SurgeryManagement
Portal Hypertension Management - Baveno VII
Portal Hypertension Management - Baveno VII: Chronic Liver Disease → CSPH Assessment → Baveno VI/VII Rule to Avoid EGD → Can Defer EGD.
Pathway Overview
11 steps
Algorithm Steps
11 total
01Start 02Action CSPH Assessment
Clinically significant portal hypertension
- HVPG ≥10 mmHg if measured
- Non-invasive: LSM ≥20-25 kPa (suggests CSPH)
- Baveno VI criteria for avoiding EGD
03Decision Baveno VI/VII Rule to Avoid EGD
- LSM <20 kPa AND platelets >150k
- Low risk of varices needing treatment
- If met: can defer EGD, repeat assessment yearly
04Action Can Defer EGD
Low risk, annual reassessment
- Path rejoins step 02Shared downstream outcome
05Action EGD Recommended
Screen for varices
06Decision Varices on EGD
- No varices
- Small varices (<5mm, no red signs)
- Medium/large varices or red signs
07Action No/Small Varices without Red Signs
Primary prophylaxis options
- NSBB (carvedilol) if CSPH confirmed
- Or repeat EGD in 1-2 years
- Treat underlying etiology
08Action NSBB Therapy
Carvedilol 6.25-12.5mg BID or propranolol
- Target: HR ~55-60, no hypotension
- Continue indefinitely if tolerated
- Stop if refractory ascites/hypotension
09End Ongoing Surveillance
Monitor for bleeding, ascites, consider transplant evaluation
- Path rejoins step 09Shared downstream outcome
10Action High-Risk Varices
Medium/large or red signs
- Primary prophylaxis mandatory
- NSBB (carvedilol preferred)
- OR EVL (band ligation)
- TIPS if refractory
- Path rejoins step 08Shared downstream outcome
11Action EVL (Band Ligation)
If NSBB contraindicated/intolerant
- Repeat q2-4 weeks until eradicated
- Then surveillance EGD
- Path rejoins step 09Shared downstream outcome
Guideline Source
Baveno VII Consensus on Portal Hypertension
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- HVPG measurement gold standard but invasive
- Non-invasive tools (elastography, platelets) increasingly used
- NSBB indicated once varices or CSPH confirmed
- Carvedilol preferred over propranolol in many settings
Applicable Regions
USAUUKEU
EU: Baveno VII consensus
US: AASLD portal hypertension guidelines
Version 1Next review: 2028-01-01
Next steps
Finish the workflow by opening the most relevant calculator, then convert the session into a live account when you are ready.
Related Resources
Frequently Asked Questions
What is the Portal Hypertension Management - Baveno VII?
The Portal Hypertension Management - Baveno VII is a management clinical algorithm for Hepatobiliary Surgery. It provides a structured decision tree to guide clinical decision-making, based on Baveno VII Consensus on Portal Hypertension.
What guideline is the Portal Hypertension Management - Baveno VII based on?
This algorithm is based on Baveno VII Consensus on Portal Hypertension (DOI: 10.1016/j.jhep.2021.12.003).
What are the limitations of the Portal Hypertension Management - Baveno VII?
Known limitations include: HVPG measurement gold standard but invasive; Non-invasive tools (elastography, platelets) increasingly used; NSBB indicated once varices or CSPH confirmed; Carvedilol preferred over propranolol in many settings. Individual patient factors may require deviation from these recommendations.
Get AI-Powered Analysis Alongside This Algorithm
In AttendMe.ai, the Portal Hypertension Management - Baveno VII appears automatically when your clinical question matches — alongside evidence from 3M+ peer-reviewed articles.
Try AttendMe Free