| Literature DB >> 29032610 |
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, Palepu Jagannath12, Takao Itoi13, Dirk J Gouma14, Yasuhisa Mori15, Shuntaro Mukai13, Mariano Eduardo 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 Santibañes31, 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.
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.Entities:
Keywords: Acute cholangitis; Diagnostic criteria; Diagnostic imaging; Guidelines; Severity grading
Mesh：
Year: 2018 PMID： 29032610 DOI： 10.1002/jhbp.512
Source DB: PubMed Journal: J Hepatobiliary Pancreat Sci ISSN： 1868-6974 Impact factor: 7.027