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World J Hepatol. Jun 27, 2025; 17(6): 104761
Published online Jun 27, 2025. doi: 10.4254/wjh.v17.i6.104761
Advances in the diagnosis and management of clinically significant portal hypertension in cirrhosis: A narrative review
Xiao-Yu Xie, Amine Benmassaoud
Xiao-Yu Xie, Faculty of Medicine, University of Montreal, Montreal H3T1J4, Quebec, Canada
Amine Benmassaoud, Department of Gastroenterology and Hepatology, McGill University Health Centre, Montreal H4A3J1, Quebec, Canada
Author contributions: Xie XY conducted the literature review, drafted the original manuscript, and created the artwork; Benmassaoud A supervised and made critical revisions; Xie XY and Benmassaoud A both worked on the conception and the design of the study; all authors have read and approved the final manuscript.
Supported by Quebec Health Research Fund Clinician Research Scholars Junior 1, No. 350546.
Conflict-of-interest statement: Xie XY has no conflicts of interest to declare; Benmassaoud A has received fees for serving as a speaker for Cook Medical, and advisory board member for Jazz Pharmaceuticals.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amine Benmassaoud, MD, Assistant Professor, Department of Gastroenterology and Hepatology, McGill University Health Centre, 1001 Decarie Blvd, Montreal H4A3J1, Quebec, Canada. amine.benmassaoud@mcgill.ca
Received: January 9, 2025
Revised: April 9, 2025
Accepted: May 18, 2025
Published online: June 27, 2025
Processing time: 167 Days and 15.5 Hours
Core Tip

Core Tip: Portal hypertension (PH) is the main driver of morbidity and mortality in patients with cirrhosis. Over the last decade, there have been many critical developments in the diagnosis and management of this condition. The following review will provide the reader with a state-of-the-art appreciation of the most recent updates in the non-invasive and invasive diagnostic approaches, including the use of liver stiffness, spleen stiffness, and endoscopic ultrasound. A diagnostic algorithm is proposed to guide clinicians. We also discuss the role of pharmacological, endoscopic, and interventional therapeutic options to prevent and manage manifestations of PH.