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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines
Journal of Hepato-Biliary-Pancreatic Surgery, Volume 14, No. 1, Year 2007
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Description
Because acute cholangitis sometimes rapidly progresses to a severe form accompanied by organ dysfunction, caused by the systemic inflammatory response syndrome (SIRS) and/or sepsis, prompt diagnosis and severity assessment are necessary for appropriate management, including intensive care with organ support and urgent biliary drainage in addition to medical treatment. However, because there have been no standard criteria for the diagnosis and severity assessment of acute cholangitis, practical clinical guidelines have never been established. The aim of this part of the Tokyo Guidelines is to propose new criteria for the diagnosis and severity assessment of acute cholangitis based on a systematic review of the literature and the consensus of experts reached at the International Consensus Meeting held in Tokyo 2006. Acute cholangitis can be diagnosed if the clinical manifestations of Charcot's triad, i.e., fever and/or chills, abdominal pain (right upper quadrant or epigastric), and jaundice are present. When not all of the components of the triad are present, then a definite diagnosis can be made if laboratory data and imaging findings supporting the evidence of inflammation and biliary obstruction are obtained. The severity of acute cholangitis can be classified into three grades, mild (grade I), moderate (grade II), and severe (grade III), on the basis of two clinical factors, the onset of organ dysfunction and the response to the initial medical treatment. "Severe (grade III)" acute cholangitis is defined as acute cholangitis accompanied by at least one new-onset organ dysfunction. "Moderate (grade II)" acute cholangitis is defined as acute cholangitis that is unaccompanied by organ dysfunction, but that does not respond to the initial medical treatment, with the clinical manifestations and/or laboratory data not improved. "Mild (grade I)" acute cholangitis is defined as acute cholangitis that responds to the initial medical treatment, with the clinical findings improved. © Springer-Verlag Tokyo 2007.
Authors & Co-Authors
Wada, Keita
Japan, Tokyo
Teikyo University School of Medicine
Takada, Tadahiro
Japan, Tokyo
Teikyo University School of Medicine
Kawarada, Yoshifumi
Japan, Tsu
Mie University Faculty of Medicine
Nimura, Yuji
Japan, Nagoya
Nagoya University Graduate School of Medicine
Miura, Fumihiko
Japan, Tokyo
Teikyo University School of Medicine
Yoshida, Masahiro
Japan, Tokyo
Teikyo University School of Medicine
Mayumi, Toshihiko
Japan, Nagoya
Nagoya University School of Medicine
Strasberg, Steven M.
United States, St. Louis
Barnes-jewish Hospital
Pitt, Henry A.
United States, Indianapolis
Indiana University School of Medicine
Gadacz, Thomas R.
United States, Augusta
Medical College of Georgia
Búchler, Markus Wolfgang
Germany, Heidelberg
Universität Heidelberg
Belghiti, Jacques B.
France, Clichy
Hôpital Beaujon
de Santibanes, Eduardo
Argentina, Buenos Aires
Universidad de Buenos Aires
Gouma, Dirk J.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Neuhaus, Horst N.
Germany, Dusseldorf
Evangelisches Krankenhaus Düsseldorf
Dervenis, Christos G.
Greece, Athens
Agia Olga Hospital
Fan, Sheung Tat
Hong Kong, Hong Kong
The University of Hong Kong
Chen, Miin Fu
Taiwan, Taoyuan
Chang Gung University
Ker, Chen Guo
Taiwan, Kaohsiung
Yuan's General Hospital Taiwan
Bornman, Philippus C.
South Africa, Cape Town
University of Cape Town
Hilvano, Serafin C.
Philippines, Manila
University of the Philippines Manila
Kim, Sunwhe
South Korea, Seoul
Seoul National University College of Medicine
Liau, Kui Hin
Singapore, Singapore City
Tan Tock Seng Hospital
Kim, Myung Hwan
South Korea, Seoul
University of Ulsan College of Medicine
Statistics
Citations: 217
Authors: 24
Affiliations: 21
Identifiers
Doi:
10.1007/s00534-006-1156-7
ISSN:
09441166
Study Approach
Systematic review