Diagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines.
Authors
Wada, KeitaTakada, 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
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
Issue Date
2007-01-25
Metadata
Show full item recordAbstract
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):52-58ae974a485f413a2113503eed53cd6c53
10.1007/s00534-006-1156-7
Scopus Count
Related articles
- Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines.
- Authors: Hirota M, Takada T, Kawarada Y, Nimura Y, Miura F, Hirata K, Mayumi T, Yoshida M, Strasberg S, Pitt H, Gadacz TR, de Santibanes E, Gouma DJ, Solomkin JS, Belghiti J, Neuhaus H, Büchler MW, Fan ST, Ker CG, Padbury RT, Liau KH, Hilvano SC, Belli G, Windsor JA, Dervenis C
- Issue date: 2007
- Background: Tokyo Guidelines for the management of acute cholangitis and cholecystitis.
- Authors: Takada T, Kawarada Y, Nimura Y, Yoshida M, Mayumi T, Sekimoto M, Miura F, Wada K, Hirota M, Yamashita Y, Nagino M, Tsuyuguchi T, Tanaka A, Kimura Y, Yasuda H, Hirata K, Pitt HA, Strasberg SM, Gadacz TR, Bornman PC, Gouma DJ, Belli G, Liau KH
- Issue date: 2007
- [Acute cholangitis].
- Authors: Zinzindohoué F
- Issue date: 2007 Dec 15
- Cardiovascular characteristics in Marfan syndrome and their relation to the genotype.
- Authors: De Backer J
- Issue date: 2009
- TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos).
- Authors: Kiriyama S, Takada T, Strasberg SM, Solomkin JS, Mayumi T, Pitt HA, Gouma DJ, Garden OJ, Büchler MW, Yokoe M, Kimura Y, Tsuyuguchi T, Itoi T, Yoshida M, Miura F, Yamashita Y, Okamoto K, Gabata T, Hata J, Higuchi R, Windsor JA, Bornman PC, Fan ST, Singh H, de Santibanes E, Gomi H, Kusachi S, Murata A, Chen XP, Jagannath P, Lee S, Padbury R, Chen MF, Dervenis C, Chan AC, Supe AN, Liau KH, Kim MH, Kim SW, Tokyo Guidelines Revision Committee
- Issue date: 2013 Jan