Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos)

Journal of Hepato-Biliary-Pancreatic Sciences - Tập 25 Số 1 - Trang 17-30 - 2018
Seiki Kiriyama1, Kazuto Kozaka2, Tadahiro Takada3, Steven M. Strasberg4, Henry A. Pitt5, Toshifumi Gabata6, Jiro Hata7, Kui‐Hin Liau8, Fumihiko Miura3, Akihiko Horiguchi9, Keng‐Hao Liu10, Cheng‐Hsi Su11, Keita Wada3, P. Jagannath12, Takao Itoi13, Dirk J. Gouma14, Yasuhisa Mori15, Shuntaro Mukai13, Mariano Giménez16,17, Wayne Shih‐Wei Huang18, Myung‐Hwan Kim19, Kohji Okamoto20, Giulio Belli21, Christos Dervenis22, Angus C. W. Chan23, Wan Yee Lau24, Itaru Endo25, Harumi Gomi26, Masahiro Yoshida27,28, Toshihiko Mayumi29, Todd H. Baron30, Eduardo de Santibáñes31, Anthony Yuen Bun Teoh32, Tsann‐Long Hwang10, Chen‐Guo Ker33, Miin‐Fu Chen10, Ho‐Seong Han34, Yoo‐Seok Yoon34, In‐Seok Choi35, Dong Sup Yoon36, Ryota Higuchi37, Seigo Kitano38, Masafumi Inomata39, Daniel J. Deziel40, Eduard Jonas41, Koichi Hirata42, Yoshinobu Sumiyama43, Kazuo Inui44, Masakazu Yamamoto36
1Department of Gastroenterology, Ogaki Municipal Hospital, Gifu, Japan
2Department of Radiology, Kanazawa University Graduate School of Medical Sciences, Ishikawa, Japan
3Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
4Section of Hepato-Pancreato-Biliary Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
5Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
6Kanazawa University Hospital, Ishikawa, Japan
7Department of Endoscopy and Ultrasound, Kawasaki Medical School, Okayama, Japan
8Mt Elizabeth Novena Hospital Singapore and Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
9Department of Gastroenterological Surgery, Fujita Health University School of Medicine, Aichi, Japan
10Division of General Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
11Department of Surgery, Cheng Hsin General Hospital, Taipei, Taiwan
12Department of Surgical Oncology, Lilavati Hospital and Research Centre, Mumbai, India
13Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Tokyo, Japan
14Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands
15Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
16DAICIM Foundation Buenos Aires Argentina
17General Surgery and Minimal Invasive Surgery “Taquini” University of Buenos Aires Buenos Aires Argentina
18Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan
19Department of Gastroenterology, University of Ulsan College of Medicine, Seoul, Korea
20Department of Surgery, Center for Gastroenterology and Liver Disease, Kitakyushu City Yahata Hospital, Fukuoka, Japan
21Department of General and HPB Surgery, Loreto Nuovo Hospital, Naples, Italy
22First Department of Surgery, Agia Olga Hospital, Athens, Greece
23Surgery Centre, Department of Surgery, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong
24Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
25Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Kanagawa, Japan
26Center for Global Health, Mito Kyodo General Hospital, University of Tsukuba, Ibaraki, Japan
27Department of EBM and Guidelines, Japan Council for Quality Health Care, Tokyo, Japan
28Department of Hemodialysis and Surgery, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
29Department of Emergency Medicine, School of Medicine University of Occupational and Environmental Health, Fukuoka, Japan
30Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
31Department of Surgery, Hospital Italiano, University of Buenos Aires, Buenos Aires, Argentina
32Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
33Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan
34Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea
35Department of Surgery, Konyang University Hospital, Daejeon, Korea
36Department of Surgery, Yonsei University Gangnam Severance Hospital, Seoul, Korea
37Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan
38Oita University, Oita, Japan
39Department of Gastroenterolgical and Pediatric Surgery, Oita University, Faculty of Medicine, Oita, Japan
40Department of Surgery, Rush University Medical Center, Chicago, USA
41Surgical Gastroenterology/Hepatopancreatobiliary Unit, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
42Department of Surgery, JR Sapporo Hospital, Hokkaido, Japan
43Toho University, Tokyo, Japan
44Department of Gastroenterology, Second Teaching Hospital, Fujita Health University, Aichi, Japan

Tóm tắt

Abstract

Although the diagnostic and severity grading criteria on the 2013 Tokyo Guidelines (TG13) are used worldwide as the primary standard for management of acute cholangitis (AC), they need to be validated through implementation and assessment in actual clinical practice. Here, we conduct a systematic review of the literature to validate the TG13 diagnostic and severity grading criteria for AC and propose TG18 criteria. While there is little evidence evaluating the TG13 criteria, they were validated through a large‐scale case series study in Japan and Taiwan. Analyzing big data from this study confirmed that the diagnostic rate of AC based on the TG13 diagnostic criteria was higher than that based on the TG07 criteria, and that 30‐day mortality in patients with a higher severity based on the TG13 severity grading criteria was significantly higher. Furthermore, a comparison of patients treated with early or urgent biliary drainage versus patients not treated this way showed no difference in 30‐day mortality among patients with Grade I or Grade III AC, but significantly lower 30‐day mortality in patients with Grade II AC who were treated with early or urgent biliary drainage. This suggests that the TG13 severity grading criteria can be used to identify Grade II patients whose prognoses may be improved through biliary drainage. The TG13 severity grading criteria may therefore be useful as an indicator for biliary drainage as well as a predictive factor when assessing the patient's prognosis. The TG13 diagnostic and severity grading criteria for AC can provide results quickly, are minimally invasive for the patients, and are inexpensive. We recommend that the TG13 criteria be adopted in the TG18 guidelines and used as standard practice in the clinical setting. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.

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Journal of Hepato-Biliary-Pancreatic Sciences

Tập 25 Số 1

17-30

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