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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos)
Journal of Hepato-Biliary-Pancreatic Sciences, Volume 20, No. 1, Year 2013
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Description
Since the publication of the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07), diagnostic criteria and severity assessment criteria for acute cholangitis have been presented and extensively used as the primary standard all over the world. However, it has been found that there are crucial limitations in these criteria. The diagnostic criteria of TG07 do not have enough sensitivity and specificity, and its severity assessment criteria are unsuitable for clinical use. A working team for the revision of TG07 was organized in June, 2010, and these criteria have been updated through clinical implementation and its assessment by means of multi-center analysis. The diagnostic criteria of acute cholangitis have been revised as criteria to establish the diagnosis where cholestasis and inflammation demonstrated by clinical signs or blood test in addition to biliary manifestations demonstrated by imaging are present. The diagnostic criteria of the updated Tokyo Guidelines (TG13) have high sensitivity (87.6 %) and high specificity (77.7 %). TG13 has better diagnostic capacity than TG07. Severity assessment is classified as follows: Grade III: associated with organ failure; Grade II: early biliary drainage should be conducted; Grade1: others. As for the severity assessment criteria of TG07, separating Grade II and Grade I at the time of diagnosis was impossible, so they were unsuitable for clinical practice. Therefore, the severity assessment criteria of TG13 have been revised so as not to lose the timing of biliary drainage or treatment for etiology. Based on evidence, five predictive factors for poor prognosis in acute cholangitis - hyperbilirubinemia, high fever, leukocytosis, elderly patient and hypoalbuminemia - have been extracted. Grade II can be diagnosed if two of these five factors are present. Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html. © 2012 Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer.
Authors & Co-Authors
Kiriyama, Seiki
Unknown Affiliation
Takada, Tadahiro
Unknown Affiliation
Strasberg, Steven M.
Unknown Affiliation
Solomkin, Joseph S.
Unknown Affiliation
Mayumi, Toshihiko
Unknown Affiliation
Pitt, Henry A.
Unknown Affiliation
Gouma, Dirk J.
Unknown Affiliation
Garden, Olivier James
Unknown Affiliation
Búchler, Markus Wolfgang
Unknown Affiliation
Yokoe, Masamichi
Unknown Affiliation
Kimura, Yasutoshi
Unknown Affiliation
Tsuyuguchi, Toshio
Unknown Affiliation
Itoi, Takao
Unknown Affiliation
Yoshida, Masahiro
Unknown Affiliation
Miura, Fumihiko
Unknown Affiliation
Yamashita, Yuichi
Unknown Affiliation
Okamoto, Kohji
Unknown Affiliation
Gabata, Toshifumi
Unknown Affiliation
Hata, Jiro
Unknown Affiliation
Higuchi, Ryota
Unknown Affiliation
Windsor, John A.
Unknown Affiliation
Bornman, Philippus C.
Unknown Affiliation
Fan, Sheung Tat
Unknown Affiliation
Singh, Harijt
Unknown Affiliation
de Santibanes, Eduardo
Unknown Affiliation
Gomi, Harumi
Unknown Affiliation
Kusachi, Shinya
Unknown Affiliation
Murata, Atsuhiko
Unknown Affiliation
Chen, Xiao Ping
Unknown Affiliation
Jagannath, Palepu
Unknown Affiliation
Lee, Sunggyu
Unknown Affiliation
Padbury, Robert T.
Unknown Affiliation
Chen, Miin Fu
Unknown Affiliation
Dervenis, Christos G.
Unknown Affiliation
Chan, Angus C.W.
Unknown Affiliation
Supe, Avinash N.
Unknown Affiliation
Liau, Kui Hin
Unknown Affiliation
Kim, Myung Hwan
Unknown Affiliation
Kim, Sunwhe
Unknown Affiliation
Statistics
Citations: 264
Authors: 39
Affiliations: 39
Identifiers
Doi:
10.1007/s00534-012-0561-3
ISSN:
18686974
e-ISSN:
18686982
Research Areas
Health System And Policy