Tokyo Guidelines 2018: initial management of acute biliary infection and flowchart for acute cholangitis

Autor: Yoshinobu Sumiyama, Eduard Jonas, Masakazu Yamamoto, Joseph S. Solomkin, Horacio J. Asbun, Takao Itoi, Eduardo de Santibañes, Naohiro Sata, Wan Yee Lau, Masafumi Inomata, Taizo Hibi, Akiko Umezawa, Angus C.W. Chan, Ryota Higuchi, Yoo Seok Yoon, Harjit Singh, Seigo Kitano, Dirk J. Gouma, Ho-Seong Han, Manabu Watanabe, Akihiko Horiguchi, Steven M. Strasberg, Giulio Belli, Seiki Kiriyama, Itaru Endo, Kenji Suzuki, David Schlossberg, Palepu Jagannath, Masamichi Yokoe, Kazuo Inui, Koji Asai, Myung-Hwan Kim, Taizo Kimura, Christos Dervenis, Koichi Hirata, Hiromi Tokumura, Yasuhisa Mori, Keng Hao Liu, Henry A. Pitt, Harumi Gomi, Cheng Hsi Su, O. James Garden, Toshiki Rikiyama, Miin Fu Chen, Kui Hin Liau, Fumihiko Miura, Shuntaro Mukai, Nobuyasu Kano, Tadahiro Takada, Mariano E Giménez, Kazuto Kozaka, Jiro Hata, Kohji Okamoto, Keita Wada, Wayne Shih Wei Huang, Yukio Iwashita, Goro Honda, Tsann Long Hwang
Přispěvatelé: Other departments
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Zdroj: Journal of hepato-biliary-pancreatic sciences, 25(1), 31-40. Wiley-Blackwell
Miura, F, Okamoto, K, Takada, T, Strasberg, S M, Asbun, H J, Pitt, H A, Gomi, H, Solomkin, J S, Schlossberg, D, Han, H, Kim, M, Hwang, T, Chen, M, Huang, W S, Kiriyama, S, Itoi, T, Garden, O J, Liau, K, Horiguchi, A, Liu, K, Su, C, Gouma, D J, Belli, G, Dervenis, C, Jagannath, P, Chan, A C W, Lau, W Y, Endo, I, Suzuki, K, Yoon, Y, De Santibañes, E, Giménez, M E, Jonas, E, Singh, H, Honda, G, Asai, K, Mori, Y, Wada, K, Higuchi, R, Watanabe, M, Rikiyama, T, Sata, N, Kano, N, Umezawa, A, Mukai, S, Tokumura, H, Hata, J, Kozaka, K, Iwashita, Y, Hibi, T, Yokoe, M, Kimura, T, Kitano, S, Inomata, M, Hirata, K, Sumiyama, Y, Inui, K & Yamamoto, M 2018, ' Tokyo Guidelines 2018: initial management of acute biliary infection and flowchart for acute cholangitis ', Journal of Hepato-Biliary-Pancreatic Sciences, vol. 25, no. 1 . https://doi.org/10.1002/jhbp.509
ISSN: 1868-6982
Popis: The initial management of patients with suspected acute biliary infection starts with the measurement of vital signs to assess whether or not the situation is urgent. If the case is judged to be urgent, initial medical treatment should be started immediately including respiratory/circulatory management if required, without waiting for a definitive diagnosis. The patient's medical history is then taken; an abdominal examination is performed; blood tests, urinalysis, and diagnostic imaging are carried out; and a diagnosis is made using the diagnostic criteria for cholangitis/cholecystitis. Once the diagnosis has been confirmed, initial medical treatment should be started immediately, severity should be assessed according to the severity grading criteria for acute cholangitis/cholecystitis, and the patient's general status should be evaluated. For mild acute cholangitis, in most cases initial treatment including antibiotics is sufficient, and most patients do not require biliary drainage. However, biliary drainage should be considered if a patient does not respond to initial treatment. For moderate acute cholangitis, early endoscopic or percutaneous transhepatic biliary drainage is indicated. If the underlying etiology requires treatment, this should be provided after the patient's general condition has improved; endoscopic sphincterotomy and subsequent choledocholithotomy may be performed together with biliary drainage. For severe acute cholangitis, appropriate respiratory/circulatory management is required. Biliary drainage should be performed as soon as possible after the patient's general condition has been improved by initial treatment and respiratory/circulatory management. 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.
Databáze: OpenAIRE
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