Bacteriological analysis of bile in acute cholecystitis according to the Tokyo guidelines

Asai, Koji; Watanabe, Manabu; Kusachi, Shozo; Tanaka, Hidenori; Miyata, Hiroshi; Osawa, Akihiro; Saito, Tomoaki; Kodama, Hajime; Enomoto, Toshiyuki; Nakamura, Yoichi; Okamoto, Yasushi; Saida, Yoshihisa; Nagao, Jirō

doi:10.1007/s00534-011-0463-9

Cited by 37 publications

(51 citation statements)

References 25 publications

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“…In studies comparing the severity grading of TG07 with those of TG13, the proportion of Grade III patients was 1.2% to 6.0% [12,13,16]; however, more recent studies have found rates of 23.3% [28] and 26% [29], and it seems to require further verification by more cases based on our own results. Wright et al described the trends in Grade III patients as follows: "Patients with Grade III acute cholecystitis were older, more likely to be male, of non-white race, and had more co-morbid conditions" [29].…”

Section: Discussioncontrasting

confidence: 51%

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Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Yokoe

Takada

Hwang

et al. 2017

J Hepato Biliary Pancreat

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Background Since the publication of the Tokyo Guidelines (TG13) for the management of acute cholecystitis (AC), multidirectional studies have been published. However, epidemiological research about AC with big data was not projected. The aim of this study was to reveal the actual clinical conditions of AC. Method The study was designed as an international multicenter retrospective study of AC in Japan and Taiwan from 2011 to 2013. The factors investigated comprised data related to demographic, history, physical examinations, laboratory and imaging findings. Based on these data, we investigated the various values of AC, and real situation with respect to severity and treatment. Results A total of 5,459 patients with AC were reviewed. Thirty-day mortality rate was 1.1%. Based on the diagnostic criteria, 4,088 patients had a definite diagnosis and 291 had a suspected diagnosis. According to the severity grading, 939 patients were classified as Grade III, 2,308 as Grade II, and 2,130 as Grade I. Cholecystectomy was performed in total of 4,266 patients and 2,765 patients had laparoscopic cholecystectomy. The main etiologies were gallbladder stones in 4,623 cases. Conclusion This epidemiological study with large population will undoubtedly contribute to establish the best practice for managing AC worldwide.

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Section: Discussioncontrasting

confidence: 51%

“…As a matter of course, taking the results of previous various evaluations about TG07 guidelines [12][13][14][15][16] into the revising process, revised guidelines were published in 2013 as TG13 [17][18][19][20].…”

mentioning

confidence: 99%

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Yokoe

Takada

Hwang

et al. 2017

J Hepato Biliary Pancreat

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“…Thus, more than half of the patients with AC were critical at presentation, stressing the necessity to initiate timely and effective empirical antibiotic therapy. Pseudomonas aeruginosa to show high rates of antimicrobial resistance [24]. Our study did not confirm these findings.…”

Section: Discussionmentioning

confidence: 51%

Antibiotic resistance pattern and clinical outcomes in acute cholecystitis: 567 consecutive worldwide patients in a prospective cohort study

Catena

Sartelli

Catena

et al. 2015

International Journal of Surgery

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“…Diverse bacterial flora in the bile and on the walls of the gallbladder of patients with cholecystitis were observed, isolated and characterized through microorganism culture techniques [9][10][11]. The most frequent pathogens in biliary infection are Gram-negative anaerobes, dominated by Escherichia coli, Klebsiella spp., Acinetobacter baumani complex, and Enterobacter spp.…”

Section: Introductionmentioning

confidence: 99%

Acute cholecystitis associated with infection of Enterobacteriaceae from gut microbiota

Liu

Yan

Luo

et al. 2015

Clinical Microbiology and Infection

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Acute cholecystitis (AC) is one of the most common surgical diseases. Bacterial infection accounts for 50% to 85% of the disease's onset. Since there is a close relationship between the biliary system and the gut, the aims of this study were to characterize and determine the influence of gut microbiota on AC, to detect the pathogenic microorganism in the biliary system, and to explore the relationship between the gut and bile microbiota of patients with AC. A total of 185 713 high-quality sequence reads were generated from the faecal samples of 15 patients and 13 healthy controls by 16S rRNA gene pyrosequencing. Patients' samples were significantly enriched in Akkermansia, Enterobacter and Escherichia/Shigella group. The healthy controls, however, showed significant enrichment of Clostridiales, Coprococcus, Coprobacillaceae, Paraprevotella, Turicibacter and TM7-3 in their faecal samples. Escherichia coli was the main biliary pathogenic microorganism, among others such as Klebsiella spp., Clostridium perfringens, Citrobacter freundii and Enterobacter cloacae in the bile of the patients. Additionally, the amount of bile endotoxin significantly correlated with the number of Enterobacteriaceae, especially E. coli. Our data indicate that Enterobacteriaceae might play essential role in the pathogenesis and/or progress of AC. This was verified in an in vivo model using a pathogenic E. coli isolated from one of the patients in guinea pigs and observed marked gallbladder inflammation and morphologic changes. This study thus provides insight which could be useful for the prevention, diagnosis and treatment of AC and related diseases by controlling the growth of Enterobacteriaceae to alleviate the infection.

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Bacteriological analysis of bile in acute cholecystitis according to the Tokyo guidelines

Cited by 37 publications

References 25 publications

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Antibiotic resistance pattern and clinical outcomes in acute cholecystitis: 567 consecutive worldwide patients in a prospective cohort study

Acute cholecystitis associated with infection of Enterobacteriaceae from gut microbiota

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