Proposed new simple scoring system to identify indications for urgent ERCP in acute cholangitis based on the Tokyo Guidelines

Abstract

This new simple scoring system allows identification of high-risk AC patients soon after admission to hospital.

Clinical evaluation of the Tokyo Guidelines 2013 for severity assessment of acute cholangitis

“…Univariate analyses and/or multivariate analyses have been used to identify many prognostic factors for AC [2,6,[14][15][16]. In the present study we attempted to identify predictors of the need of urgent/early biliary drainage.…”

Comparison of two editions of Tokyo guidelines for the management of acute cholangitis

“…Since 2007 when the Tokyo Guidelines for AC were originally proposed, the guidelines continued to be validated and commented on [11][12][13][14]17] until the new 2013 edition was published [15]. However, few data were available outside Japan.…”

“…For severity assessment, a 24‐h time period was needed by TG07 to observe clinical response to conservative treatment necessary to separate the mild and moderate cases . Such criterion has been argued due to the inability to assess the severity upon admission and conduct biliary drainage immediately, potentially inducing treatment delay and subsequent sepsis progression . In contrast, the TG13 appear more straightforward and practical for physicians.…”

Worsening of Acute Cholangitis Caused by a Bile Duct Stone After Hospitalization: A Case Series

“…The Evidence-Based Practice Guidelines for the Management of Acute Cholangitis and Cholecystitis (JG05) were published in Japanese in 2005 [ 2 ]. Following an international consensus meeting in 2005, the Tokyo Guidelines 2007 (TG07) for patients with acute cholangitis [ 3 , 4 ] was the first set of international guidelines that specifically addresses the problem of diagnosis and severity of acute cholangitis [ 5 , 6 ]. Although the 2005 and 2007 guidelines are of merit, there was a need to merge their recommendations.…”