Prophylaxis of decompensation – focus on portal hypertension

While until recently the rule was to initiate beta-blocker therapy only when varices occurred, it has recently been recommended to prescribe beta-blockers early and regardless of the stage of the varices. This treatment strategy has been shown to improve long-term survival and reduce the risk of decompensation events. In patients with already decompensated liver cirrhosis, there is a survival advantage if the TIPS (transjugal intrahepatic portosystemic shunt) is placed early in secondary prophylaxis.