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Article: Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines

TitleFlowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines
Authors
KeywordsAcute cholecystitis
Biliary
Cholangitis
Cholecystec-tomy
Drainage
Guidelines
Laparoscopic cholecystectomy
Issue Date2007
PublisherSpringer Japan. The Journal's web site is located at http://link.springer.de/link/service/journals/00534/index.htm
Citation
Journal Of Hepato-Biliary-Pancreatic Surgery, 2007, v. 14 n. 1, p. 27-34 How to Cite?
AbstractDiagnostic and therapeutic strategies for acute biliary inflammation/ infection (acute cholangitis and acute cholecystitis), according to severity grade, have not yet been established in the world. Therefore we formulated flowcharts for the management of acute biliary inflammation/ infection in accordance with severity grade. For mild (grade I) acute cholangitis, medical treatment may be sufficient/appropriate. For moderate (grade II) acute cholangitis, early biliary drainage should be performed. For severe (grade III) acute cholangitis, appropriate organ support such as ventilatory/circulatory management is required. After hemodynamic stabilization is achieved, urgent endoscopic or percutaneous transhepatic biliary drainage should be performed. For patients with acute cholangitis of any grade of severity, treatment for the underlying etiology, including endoscopic, percutaneous, or surgical treatment should be performed after the patient's general condition has improved. For patients with mild (grade I) cholecystitis, early laparoscopic cholecystectomy is the preferred treatment. For patients with moderate (grade II) acute cholecystitis, early laparoscopic or open cholecystectomy is preferred. In patients with extensive local inflammation, elective cholecystectomy is recommended after initial management with percutaneous gallbladder drainage and/or cholecystostomy. For the patient with severe (grade III) acute cholecystitis, multiorgan support is a critical part of management. Biliary peritonitis due to perforation of the gallbladder is an indication for urgent cholecystectomy and/or drainage. Delayed elective cholecystectomy may be performed after initial treatment with gallbladder drainage and improvement of the patient's general medical condition. © Springer-Verlag Tokyo 2007.
Persistent Identifierhttp://hdl.handle.net/10722/83378
ISSN
2009 Impact Factor: 1.601
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMiura, Fen_HK
dc.contributor.authorTakada, Ten_HK
dc.contributor.authorKawarada, Yen_HK
dc.contributor.authorNimura, Yen_HK
dc.contributor.authorWada, Ken_HK
dc.contributor.authorHirota, Men_HK
dc.contributor.authorNagino, Men_HK
dc.contributor.authorTsuyuguchi, Ten_HK
dc.contributor.authorMayumi, Ten_HK
dc.contributor.authorYoshida, Men_HK
dc.contributor.authorStrasberg, SMen_HK
dc.contributor.authorPitt, HAen_HK
dc.contributor.authorBelghiti, Jen_HK
dc.contributor.authorde Santibanes, Een_HK
dc.contributor.authorGadacz, TRen_HK
dc.contributor.authorGouma, DJen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorChen, MFen_HK
dc.contributor.authorPadbury, RTen_HK
dc.contributor.authorBornman, PCen_HK
dc.contributor.authorKim, SWen_HK
dc.contributor.authorLiau, KHen_HK
dc.contributor.authorBelli, Gen_HK
dc.contributor.authorDervenis, Cen_HK
dc.date.accessioned2010-09-06T08:40:19Z-
dc.date.available2010-09-06T08:40:19Z-
dc.date.issued2007en_HK
dc.identifier.citationJournal Of Hepato-Biliary-Pancreatic Surgery, 2007, v. 14 n. 1, p. 27-34en_HK
dc.identifier.issn0944-1166en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83378-
dc.description.abstractDiagnostic and therapeutic strategies for acute biliary inflammation/ infection (acute cholangitis and acute cholecystitis), according to severity grade, have not yet been established in the world. Therefore we formulated flowcharts for the management of acute biliary inflammation/ infection in accordance with severity grade. For mild (grade I) acute cholangitis, medical treatment may be sufficient/appropriate. For moderate (grade II) acute cholangitis, early biliary drainage should be performed. For severe (grade III) acute cholangitis, appropriate organ support such as ventilatory/circulatory management is required. After hemodynamic stabilization is achieved, urgent endoscopic or percutaneous transhepatic biliary drainage should be performed. For patients with acute cholangitis of any grade of severity, treatment for the underlying etiology, including endoscopic, percutaneous, or surgical treatment should be performed after the patient's general condition has improved. For patients with mild (grade I) cholecystitis, early laparoscopic cholecystectomy is the preferred treatment. For patients with moderate (grade II) acute cholecystitis, early laparoscopic or open cholecystectomy is preferred. In patients with extensive local inflammation, elective cholecystectomy is recommended after initial management with percutaneous gallbladder drainage and/or cholecystostomy. For the patient with severe (grade III) acute cholecystitis, multiorgan support is a critical part of management. Biliary peritonitis due to perforation of the gallbladder is an indication for urgent cholecystectomy and/or drainage. Delayed elective cholecystectomy may be performed after initial treatment with gallbladder drainage and improvement of the patient's general medical condition. © Springer-Verlag Tokyo 2007.en_HK
dc.languageengen_HK
dc.publisherSpringer Japan. The Journal's web site is located at http://link.springer.de/link/service/journals/00534/index.htmen_HK
dc.relation.ispartofJournal of Hepato-Biliary-Pancreatic Surgeryen_HK
dc.subjectAcute cholecystitisen_HK
dc.subjectBiliaryen_HK
dc.subjectCholangitisen_HK
dc.subjectCholecystec-tomyen_HK
dc.subjectDrainageen_HK
dc.subjectGuidelinesen_HK
dc.subjectLaparoscopic cholecystectomyen_HK
dc.titleFlowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelinesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0944-1166&volume=14&issue=1&spage=27&epage=34&date=2007&atitle=Flowcharts+for+the+diagnosis+and+treatment+of+acute+cholangitis+and+cholecystitis:+Tokyo+Guidelinesen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1007/s00534-006-1153-xen_HK
dc.identifier.pmid17252294en_HK
dc.identifier.scopuseid_2-s2.0-33846674195en_HK
dc.identifier.hkuros125976en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33846674195&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issue1en_HK
dc.identifier.spage27en_HK
dc.identifier.epage34en_HK
dc.identifier.isiWOS:000245342900005-
dc.publisher.placeJapanen_HK
dc.identifier.scopusauthoridMiura, F=35475649700en_HK
dc.identifier.scopusauthoridTakada, T=7202751961en_HK
dc.identifier.scopusauthoridKawarada, Y=7102270197en_HK
dc.identifier.scopusauthoridNimura, Y=7201351672en_HK
dc.identifier.scopusauthoridWada, K=8973796100en_HK
dc.identifier.scopusauthoridHirota, M=7201993802en_HK
dc.identifier.scopusauthoridNagino, M=7006620971en_HK
dc.identifier.scopusauthoridTsuyuguchi, T=6701437594en_HK
dc.identifier.scopusauthoridMayumi, T=7102413301en_HK
dc.identifier.scopusauthoridYoshida, M=14421962900en_HK
dc.identifier.scopusauthoridStrasberg, SM=7101931401en_HK
dc.identifier.scopusauthoridPitt, HA=7103213587en_HK
dc.identifier.scopusauthoridBelghiti, J=35403099400en_HK
dc.identifier.scopusauthoridde Santibanes, E=15057704700en_HK
dc.identifier.scopusauthoridGadacz, TR=7006317671en_HK
dc.identifier.scopusauthoridGouma, DJ=36046572200en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridChen, MF=34874546600en_HK
dc.identifier.scopusauthoridPadbury, RT=6603924012en_HK
dc.identifier.scopusauthoridBornman, PC=7006718164en_HK
dc.identifier.scopusauthoridKim, SW=36063168700en_HK
dc.identifier.scopusauthoridLiau, KH=15837148100en_HK
dc.identifier.scopusauthoridBelli, G=7004998933en_HK
dc.identifier.scopusauthoridDervenis, C=7003990635en_HK
dc.identifier.citeulike1100220-

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