Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines

Miura, Fumihiko; Takada, Tadahiro; Kawarada, Yoshifumi; Nimura, Yuji; Wada, Keita; Hirota, Masahiko; Nagino, Masato; Tsuyuguchi, Toshio; Mayumi, Toshihiko; Yoshida, Masahiro; Strasberg, Steven M.; Pitt, Henry A.; Belghiti, Jacques; Santibañés, Eduardo de; Gadacz, Thomas R.; Gouma, Dirk J.; Fan, Sheung Tat; Chen, Miin Fu; Padbury, Robert; Bornman, Philippus C.; Kim, Sun Whe; Liau, Kui Hin; Belli, Giulio; Dervenis, Christos

doi:10.1007/s00534-006-1153-x

Cited by 166 publications

(121 citation statements)

References 20 publications

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“…Treatment of cholecystitis depends on disease severity and patient comorbidities [2,3]. Mild cholecystitis in a low operative risk patient is treated by laparoscopic early cholecystectomy [4,5].…”

Section: Introductionmentioning

confidence: 99%

Admission CRP Level as an Indicator for the Need of Percutaneous Cholecystostomy in Acute Cholecystitis

Nizri¹,

Epstein²

2016

J Gastrointest Dig Syst

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Section: Introductionmentioning

confidence: 99%

Admission CRP Level as an Indicator for the Need of Percutaneous Cholecystostomy in Acute Cholecystitis

Nizri¹,

Epstein²

2016

J Gastrointest Dig Syst

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“…Pri blagi obliki vnetja (stopnja 1) gre najpogosteje za okužbo z Escherichio coli, zato se priporoča zdravljenje z enim antibiotikom (Tabela 2). V prvi vrsti se priporoča uvedba amoksicilina s klavulonsko kislino v peroralni obliki (19,20). Od preostalih antibiotikov lahko uvedemo kombinacijo ciprofloksacina in metronidazola v intravenski ali peroralni obliki ter ertapenem v intravenski obliki.…”

Section: Konzervativno Zdravljenjeunclassified

Akutno vnetje žolčnika – zgodnja operacija ali poskus konzervativnega zdravljenja?

Janež¹

2018

SlovMedJour

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IzvlečekAkutno vnetje žolčnika oziroma akutni holecistitis je pogosta bolezen, ki večkrat zahteva sprejem v bolnišnico in kirurško zdravljenje. Najpogosteje se pojavlja pri ljudeh, ki imajo žolčne kamne, pojavi pa se lahko tudi v odsotnosti žolčnih kamnov. Diagnozo akutnega holecistitisa postavimo na osnovi klinične slike, laboratorijskih izvidov in ultrazvoka trebuha. Algoritmi za bolnike, ki imajo akutno vnetje žolčnika brez pridruženih bolezni, so znani; odločitev za kirurški poseg pri bolnikih s pridruženimi boleznimi pa je odvisna od več dejavnikov. Laparoskopska holecistektomija je metoda izbire zdravljenja bolnikov z akutnim holecistitisom. Rezultati zdravljenja so bistveno boljši, kadar kirurški poseg napravimo znotraj 72 ur od nastopa kliničnih znakov.V prispevku so predstavljena najnovejša priporočila za obravnavo bolnikov z akutnim holecistitisom, povzeta po smernicah iz Tokia ter smernicah Svetovnega združenja za urgentno kirurgijo iz leta 2016 ter na koncu še izsledki in izkušnje nekaterih kliničnih študij in metaanaliz. AbstractAcute cholecystitis is a common disease, which often requires admission to hospital and surgical treatment. Acute cholecystitis is defined as inflammation of the gallbladder and usually occurs due to cystic duct obstruction from stones or sludge. It is a relatively common complication of gallstones, but it can also occur without gallstones. A combination of relevant clinical symptoms and ultrasound evidence is required to make a diagnosis of acute cholecystitis. Early surgery is recommended for all patients that are in good physical condition. There is still a debate how to treat high-risk and critically ill patients. Laparoscopic cholecystectomy is the method of choice for treatment of patients with acute cholecystitis. Early laparoscopic cholecystectomy should be done within 72 hours from the onset of symptoms. This article presents current guidelines according to the Tokyo guidelines and the World Society of Emergency Surgery guidelines, and at the end, experiences of some clinical trials. UvodAkutno vnetje žolčnika oziroma akutni holecistitis je pogosto bolezen, ki velikokrat zahteva bolnišnično zdravljenje in operacijo. Najpogosteje se pojavlja pri ljudeh z žolčnimi kamni, lahko pa tudi brez njih (1). Vnetje žolčnika brez prisotnosti kamnov je pogostejše pri kritično bolnih, ki so dlje časa na parenteralni prehrani, pri politravmatiziranih bolnikih, pri večjih opeklinah in pri bolnikih po srčnih operacijah (2). Akutni holecistitis je še posebej pogost vzrok

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“…Jaundice implies different syndromic, anatomical, and etiological diagnoses whose treatment may involve different health care settings and time, thus justifying the CRP elaboration. 11,12 Theoretical Considerations Jaundice is a clinical sign characterised by yellow skin, mucosa, and sclera resulting from an increased production of bilirubin, usually over 2.5 and 3.0 mg/dl. Bilirubin is produced by the degradation of complex proteins, mainly haemoglobin, and is then metabolised in the liver by hepatocytes in a process called capture .…”

Section: Clinical and Regulatory Protocol For Obstructive Jaundice Inmentioning

confidence: 99%

“…Moreover, these patients can be treated in a moderate complexity hospital or referred to specialised care services for adequate treatment conclusion. 11,12,20 Scenario IV…”

Section: Clinical Evaluationmentioning

confidence: 99%

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Clinical and regulatory protocol for the treatment of jaundice in adults and elderly subjects: a support for the health care network and regulatory system

Santos¹,

Kemp²,

Sankarankutty³

et al. 2008

Acta Cir. Bras.

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PURPOSE: Clinical interventions and controlled access to the health care system can be improved by a Regulatory System (RS) and Clinical and Regulatory Protocols (CRPs). The objective of the present paper is to present the methodology used for elaborating the CRPs. METHODS: The process used to elaborate the CPRs involved a scientific co-operation between university and health care system. Workshops were held and attended by primary care practitioners, RS team, and matrix team (university specialists supporting primary care practitioners). RESULTS: The treatment of jaundice in adults and elderly subjects is amongst the themes selected for elaborating the CRPs since jaundice is a medical sign frequently seen in four clinical scenarios involving distinctive diagnostic and therapeutic interventions which can be performed in different health care settings. Evaluation guidelines as well as the clinical and regulatory procedures were established for different health care settings. The most relevant clinical and regulatory interventions were expressed as algorithms in order to facilitate the use of CRPs by health care practitioners. CONCLUSION: It is expected that the implementation of this protocol will minimise the imbalance between the icteric patients' needs and the treatment modalities being offered, thus contributing to a more co-operative health care network.

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Flowcharts for the diagnosis and treatment of acute cholangitis and cholecystitis: Tokyo Guidelines

Cited by 166 publications

References 20 publications

Admission CRP Level as an Indicator for the Need of Percutaneous Cholecystostomy in Acute Cholecystitis

Admission CRP Level as an Indicator for the Need of Percutaneous Cholecystostomy in Acute Cholecystitis

Akutno vnetje žolčnika – zgodnja operacija ali poskus konzervativnega zdravljenja?

Clinical and regulatory protocol for the treatment of jaundice in adults and elderly subjects: a support for the health care network and regulatory system

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