Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines.

Hdl Handle:
http://hdl.handle.net/10675.2/138
Title:
Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines.
Authors:
Wada, Keita; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Miura, Fumihiko; Yoshida, Masahiro; Mayumi, Toshihiko; Strasberg, Steven M; Pitt, Henry A; Gadacz, Thomas R; Belghiti, Jacques; de Santibanes, Eduardo ( 0000-0002-5788-9694 ) ; Gouma, Dirk J; Neuhaus, Horst; Dervenis, Christos; Fan, Sheung-Tat; Chen, Miin-Fu; Ker, Chen-Guo; Bornman, Philippus C; Hilvano, Serafin C; Kim, Sun-Whe; Liau, Kui-Hin; Kim, Myung-Hwan; Büchler, Markus W
Abstract:
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.
Citation:
J Hepatobiliary Pancreat Surg. 2007 Jan 30; 14(1):52-58
Issue Date:
25-Jan-2007
URI:
http://hdl.handle.net/10675.2/138
DOI:
10.1007/s00534-006-1156-7
PubMed ID:
17252297
PubMed Central ID:
PMC2784515
Type:
Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't
ISSN:
0944-1166
Appears in Collections:
Department of Surgery: Faculty Research and Presentations

Full metadata record

DC FieldValue Language
dc.contributor.authorWada, Keitaen_US
dc.contributor.authorTakada, Tadahiroen_US
dc.contributor.authorKawarada, Yoshifumien_US
dc.contributor.authorNimura, Yujien_US
dc.contributor.authorMiura, Fumihikoen_US
dc.contributor.authorYoshida, Masahiroen_US
dc.contributor.authorMayumi, Toshihikoen_US
dc.contributor.authorStrasberg, Steven Men_US
dc.contributor.authorPitt, Henry Aen_US
dc.contributor.authorGadacz, Thomas Ren_US
dc.contributor.authorBelghiti, Jacquesen_US
dc.contributor.authorde Santibanes, Eduardoen_US
dc.contributor.authorGouma, Dirk Jen_US
dc.contributor.authorNeuhaus, Horsten_US
dc.contributor.authorDervenis, Christosen_US
dc.contributor.authorFan, Sheung-Taten_US
dc.contributor.authorChen, Miin-Fuen_US
dc.contributor.authorKer, Chen-Guoen_US
dc.contributor.authorBornman, Philippus Cen_US
dc.contributor.authorHilvano, Serafin Cen_US
dc.contributor.authorKim, Sun-Wheen_US
dc.contributor.authorLiau, Kui-Hinen_US
dc.contributor.authorKim, Myung-Hwanen_US
dc.contributor.authorBüchler, Markus Wen_US
dc.date.accessioned2010-09-24T22:03:26Z-
dc.date.available2010-09-24T22:03:26Z-
dc.date.issued2007-01-25en_US
dc.identifier.citationJ Hepatobiliary Pancreat Surg. 2007 Jan 30; 14(1):52-58en_US
dc.identifier.issn0944-1166en_US
dc.identifier.pmid17252297en_US
dc.identifier.doi10.1007/s00534-006-1156-7en_US
dc.identifier.urihttp://hdl.handle.net/10675.2/138-
dc.description.abstractBecause 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.en_US
dc.rightsThe PMC Open Access Subset is a relatively small part of the total collection of articles in PMC. Articles in the PMC Open Access Subset are still protected by copyright, but are made available under a Creative Commons or similar license that generally allows more liberal redistribution and reuse than a traditional copyrighted work. Please refer to the license statement in each article for specific terms of use. The license terms are not identical for all articles in this subset.en_US
dc.subject.meshAcute Diseaseen_US
dc.subject.meshCholangitis / blood / classification / diagnosisen_US
dc.subject.meshHumansen_US
dc.subject.meshPrognosisen_US
dc.subject.meshSeverity of Illness Indexen_US
dc.titleDiagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines.en_US
dc.typeJournal Articleen_US
dc.typePractice Guidelineen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
dc.identifier.pmcidPMC2784515en_US
dc.contributor.corporatenameDepartment of Surgeryen_US

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