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

TitleDiagnostic criteria and severity assessment of acute cholangitis: Tokyo Guidelines
Authors
KeywordsCholangitis
Diagnosis
Guidelines
Severity of illness index
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. 52-58 How to Cite?
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. © Springer-Verlag Tokyo 2007.
Persistent Identifierhttp://hdl.handle.net/10722/83399
ISSN
2009 Impact Factor: 1.601
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWada, Ken_HK
dc.contributor.authorTakada, Ten_HK
dc.contributor.authorKawarada, Yen_HK
dc.contributor.authorNimura, Yen_HK
dc.contributor.authorMiura, Fen_HK
dc.contributor.authorYoshida, Men_HK
dc.contributor.authorMayumi, Ten_HK
dc.contributor.authorStrasberg, Sen_HK
dc.contributor.authorPitt, HAen_HK
dc.contributor.authorGadacz, TRen_HK
dc.contributor.authorBüchler, MWen_HK
dc.contributor.authorBelghiti, Jen_HK
dc.contributor.authorde Santibanes, Een_HK
dc.contributor.authorGouma, DJen_HK
dc.contributor.authorNeuhaus, Hen_HK
dc.contributor.authorDervenis, Cen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorChen, MFen_HK
dc.contributor.authorKer, CGen_HK
dc.contributor.authorBornman, PCen_HK
dc.contributor.authorHilvano, SCen_HK
dc.contributor.authorKim, SWen_HK
dc.contributor.authorLiau, KHen_HK
dc.contributor.authorKim, MHen_HK
dc.date.accessioned2010-09-06T08:40:34Z-
dc.date.available2010-09-06T08:40:34Z-
dc.date.issued2007en_HK
dc.identifier.citationJournal Of Hepato-Biliary-Pancreatic Surgery, 2007, v. 14 n. 1, p. 52-58en_HK
dc.identifier.issn0944-1166en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83399-
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. © 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.subjectCholangitisen_HK
dc.subjectDiagnosisen_HK
dc.subjectGuidelinesen_HK
dc.subjectSeverity of illness indexen_HK
dc.titleDiagnostic criteria and severity assessment of acute cholangitis: 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=52&epage=58&date=2007&atitle=Diagnostic+criteria+and+severity+assessment+of+acute+cholangitis:+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/s00534-006-1156-7en_HK
dc.identifier.pmid17252297-
dc.identifier.scopuseid_2-s2.0-33846664697en_HK
dc.identifier.hkuros125978en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33846664697&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume14en_HK
dc.identifier.issue1en_HK
dc.identifier.spage52en_HK
dc.identifier.epage58en_HK
dc.identifier.isiWOS:000245342900010-
dc.publisher.placeJapanen_HK
dc.identifier.scopusauthoridWada, K=8973796100en_HK
dc.identifier.scopusauthoridTakada, T=7202751961en_HK
dc.identifier.scopusauthoridKawarada, Y=7102270197en_HK
dc.identifier.scopusauthoridNimura, Y=7201351672en_HK
dc.identifier.scopusauthoridMiura, F=35475649700en_HK
dc.identifier.scopusauthoridYoshida, M=14421962900en_HK
dc.identifier.scopusauthoridMayumi, T=7102413301en_HK
dc.identifier.scopusauthoridStrasberg, S=7101931401en_HK
dc.identifier.scopusauthoridPitt, HA=7103213587en_HK
dc.identifier.scopusauthoridGadacz, TR=7006317671en_HK
dc.identifier.scopusauthoridBüchler, MW=35277875400en_HK
dc.identifier.scopusauthoridBelghiti, J=35403099400en_HK
dc.identifier.scopusauthoridde Santibanes, E=15057704700en_HK
dc.identifier.scopusauthoridGouma, DJ=36046572200en_HK
dc.identifier.scopusauthoridNeuhaus, H=7101811971en_HK
dc.identifier.scopusauthoridDervenis, C=7003990635en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridChen, MF=34874546600en_HK
dc.identifier.scopusauthoridKer, CG=7005769410en_HK
dc.identifier.scopusauthoridBornman, PC=7006718164en_HK
dc.identifier.scopusauthoridHilvano, SC=6603194000en_HK
dc.identifier.scopusauthoridKim, SW=36063168700en_HK
dc.identifier.scopusauthoridLiau, KH=15837148100en_HK
dc.identifier.scopusauthoridKim, MH=16022356200en_HK
dc.identifier.citeulike1100217-

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