TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos)

摘要: Since the publication of Tokyo Guidelines for management acute cholangitis and cholecystitis (TG07), diagnostic criteria severity assessment have been presented extensively used as primary standard all over world. However, it has found that there are crucial limitations in these criteria. The TG07 do not enough sensitivity specificity, its unsuitable clinical use. A working team revision was organized June, 2010, updated through implementation by means multi-center analysis. revised to establish diagnosis where cholestasis inflammation demonstrated signs or blood test addition biliary manifestations imaging present. (TG13) high (87.6 %) specificity (77.7 %). TG13 better capacity than TG07. Severity is classified follows: Grade III: associated with organ failure; II: early drainage should be conducted; Grade1: others. As TG07, separating II I at time impossible, so they were practice. Therefore, lose timing treatment etiology. Based on evidence, five predictive factors poor prognosis cholangitis––hyperbilirubinemia, fever, leukocytosis, elderly patient hypoalbuminemia––have extracted. can diagnosed if two