The Experts below are selected from a list of 46347 Experts worldwide ranked by ideXlab platform
Henry A. Pitt - One of the best experts on this subject based on the ideXlab platform.
-
TG13 surgical management of acute Cholecystitis.
Journal of Hepato-Biliary-Pancreatic Sciences, 2013Co-Authors: Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, Harumi Gomi, Christos Dervenis, John A. WindsorAbstract:Background Laparoscopic cholecystectomy is now accepted as a surgical procedure for acute Cholecystitis when it is performed by an expert surgeon. There are several lines of strong evidence, such as randomized controlled trials (RCTs) and meta-analyses, supporting the introduction of laparoscopic cholecystectomy for patients with acute Cholecystitis. The updated Tokyo Guidelines 2013 (TG13) describe the surgical treatment for acute Cholecystitis according to the grade of severity, the timing, and the procedure used for Cholecystitis in a question-and-answer format using the evidence concerning surgical management of acute Cholecystitis.
-
tg13 current terminology etiology and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, James O Garden, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13).
-
TG13 current terminology, etiology, and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-Biliary-Pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13). Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html .
-
new diagnostic criteria and severity assessment of acute Cholecystitis in revised tokyo guidelines
Journal of Hepato-biliary-pancreatic Sciences, 2012Co-Authors: Masamichi Yokoe, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Harumi Gomi, Toshihiko Mayumi, James O Garden, Joseph S Solomkin, Markus W. BüchlerAbstract:Background The Tokyo Guidelines for the management of acute cholangitis and Cholecystitis (TG07) were published in 2007 as the world’s first guidelines for acute cholangitis and Cholecystitis. The diagnostic criteria and severity assessment of acute Cholecystitis have since been widely used all over the world. A validation study of TG07 has shown that the diagnostic criteria for acute Cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. In addition, considerable new evidence referring to acute Cholecystitis as well as evaluations of TG07 have been published. Consequently, we organized the Tokyo Guidelines Revision Committee to evaluate TG07, recognize new evidence, and conduct a multi-center analysis to revise the guidelines (TG13).
-
surgical treatment of patients with acute Cholecystitis tokyo guidelines
Journal of Hepato-biliary-pancreatic Surgery, 2007Co-Authors: Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Yoshifumi Kawarada, Yuji Nimura, Masahiko Hirota, Fumihiko Miura, Toshihiko Mayumi, Masahiro Yoshida, Henry A. PittAbstract:Cholecystectomy has been widely performed in the treatment of acute Cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute Cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute Cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute Cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute Cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute Cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute Cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute Cholecystitis in a question-and-answer format.
Tadahiro Takada - One of the best experts on this subject based on the ideXlab platform.
-
TG13 surgical management of acute Cholecystitis.
Journal of Hepato-Biliary-Pancreatic Sciences, 2013Co-Authors: Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, Harumi Gomi, Christos Dervenis, John A. WindsorAbstract:Background Laparoscopic cholecystectomy is now accepted as a surgical procedure for acute Cholecystitis when it is performed by an expert surgeon. There are several lines of strong evidence, such as randomized controlled trials (RCTs) and meta-analyses, supporting the introduction of laparoscopic cholecystectomy for patients with acute Cholecystitis. The updated Tokyo Guidelines 2013 (TG13) describe the surgical treatment for acute Cholecystitis according to the grade of severity, the timing, and the procedure used for Cholecystitis in a question-and-answer format using the evidence concerning surgical management of acute Cholecystitis.
-
tg13 current terminology etiology and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, James O Garden, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13).
-
TG13 current terminology, etiology, and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-Biliary-Pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13). Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html .
-
new diagnostic criteria and severity assessment of acute Cholecystitis in revised tokyo guidelines
Journal of Hepato-biliary-pancreatic Sciences, 2012Co-Authors: Masamichi Yokoe, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Harumi Gomi, Toshihiko Mayumi, James O Garden, Joseph S Solomkin, Markus W. BüchlerAbstract:Background The Tokyo Guidelines for the management of acute cholangitis and Cholecystitis (TG07) were published in 2007 as the world’s first guidelines for acute cholangitis and Cholecystitis. The diagnostic criteria and severity assessment of acute Cholecystitis have since been widely used all over the world. A validation study of TG07 has shown that the diagnostic criteria for acute Cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. In addition, considerable new evidence referring to acute Cholecystitis as well as evaluations of TG07 have been published. Consequently, we organized the Tokyo Guidelines Revision Committee to evaluate TG07, recognize new evidence, and conduct a multi-center analysis to revise the guidelines (TG13).
-
surgical treatment of patients with acute Cholecystitis tokyo guidelines
Journal of Hepato-biliary-pancreatic Surgery, 2007Co-Authors: Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Yoshifumi Kawarada, Yuji Nimura, Masahiko Hirota, Fumihiko Miura, Toshihiko Mayumi, Masahiro Yoshida, Henry A. PittAbstract:Cholecystectomy has been widely performed in the treatment of acute Cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute Cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute Cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute Cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute Cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute Cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute Cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute Cholecystitis in a question-and-answer format.
Masahiro Yoshida - One of the best experts on this subject based on the ideXlab platform.
-
TG13 current terminology, etiology, and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-Biliary-Pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13). Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html .
-
tg13 current terminology etiology and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, James O Garden, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13).
-
surgical treatment of patients with acute Cholecystitis tokyo guidelines
Journal of Hepato-biliary-pancreatic Surgery, 2007Co-Authors: Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Yoshifumi Kawarada, Yuji Nimura, Masahiko Hirota, Fumihiko Miura, Toshihiko Mayumi, Masahiro Yoshida, Henry A. PittAbstract:Cholecystectomy has been widely performed in the treatment of acute Cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute Cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute Cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute Cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute Cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute Cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute Cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute Cholecystitis in a question-and-answer format.
-
Background: Tokyo Guidelines for the management of acute cholangitis and Cholecystitis
Journal of Hepato-Biliary-Pancreatic Surgery, 2007Co-Authors: Tadahiro Takada, Yoshifumi Kawarada, Yuji Nimura, Masahiko Hirota, Fumihiko Miura, Toshihiko Mayumi, Masahiro Yoshida, Miho Sekimoto, Keita Wada, Yuichi YamashitaAbstract:There are no evidence-based-criteria for the diagnosis, severity assessment, of treatment of acute cholecysitis or acute cholangitis. For example, the full complement of symptoms and signs described as Charcot’s triad and as Reynolds’ pentad are infrequent and as such do not really assist the clinician with planning management strategies. In view of these factors, we launched a project to prepare evidence-based guidelines for the management of acute cholangitis and Cholecystitis that will be useful in the clinical setting. This research has been funded by the Japanese Ministry of Health, Labour, and Welfare, in cooperation with the Japanese Society for Abdominal Emergency Medicine, the Japan Biliary Association, and the Japanese Society of Hepato-Biliary-Pancreatic Surgery. A working group, consisting of 46 experts in gastroenterology, surgery, internal medicine, emergency medicine, intensive care, and clinical epidemiology, analyzed and examined the literature on patients with cholangitis and Cholecystitis in order to produce evidence-based guidelines. During the investigations we found that there was a lack of high-level evidence, for treatments, and the working group formulated the guidelines by obtaining consensus, based on evidence categorized by level, according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence of May 2001 (version 1). This work required more than 20 meetings to obtain a consensus on each item from the working group. Then four forums were held to permit examination of the Guideline details in Japan, both by an external assessment committee and by the working group participants (version 2). As we knew that the diagnosis and management of acute biliary infection may differ from country to country, we appointed a publication committee and held 12 meetings to prepare draft Guidelines in English (version 3). We then had several discussions on these draft guidelines with leading experts in the field throughout the world, via e-mail, leading to version 4. Finally, an International Consensus Meeting took place in Tokyo, on 1–2 April, 2006, to obtain international agreement on diagnostic criteria, severity assessment, and management.
Steven M. Strasberg - One of the best experts on this subject based on the ideXlab platform.
-
TG13 surgical management of acute Cholecystitis.
Journal of Hepato-Biliary-Pancreatic Sciences, 2013Co-Authors: Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, Harumi Gomi, Christos Dervenis, John A. WindsorAbstract:Background Laparoscopic cholecystectomy is now accepted as a surgical procedure for acute Cholecystitis when it is performed by an expert surgeon. There are several lines of strong evidence, such as randomized controlled trials (RCTs) and meta-analyses, supporting the introduction of laparoscopic cholecystectomy for patients with acute Cholecystitis. The updated Tokyo Guidelines 2013 (TG13) describe the surgical treatment for acute Cholecystitis according to the grade of severity, the timing, and the procedure used for Cholecystitis in a question-and-answer format using the evidence concerning surgical management of acute Cholecystitis.
-
tg13 current terminology etiology and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, James O Garden, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13).
-
TG13 current terminology, etiology, and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-Biliary-Pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13). Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html .
-
new diagnostic criteria and severity assessment of acute Cholecystitis in revised tokyo guidelines
Journal of Hepato-biliary-pancreatic Sciences, 2012Co-Authors: Masamichi Yokoe, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Harumi Gomi, Toshihiko Mayumi, James O Garden, Joseph S Solomkin, Markus W. BüchlerAbstract:Background The Tokyo Guidelines for the management of acute cholangitis and Cholecystitis (TG07) were published in 2007 as the world’s first guidelines for acute cholangitis and Cholecystitis. The diagnostic criteria and severity assessment of acute Cholecystitis have since been widely used all over the world. A validation study of TG07 has shown that the diagnostic criteria for acute Cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. In addition, considerable new evidence referring to acute Cholecystitis as well as evaluations of TG07 have been published. Consequently, we organized the Tokyo Guidelines Revision Committee to evaluate TG07, recognize new evidence, and conduct a multi-center analysis to revise the guidelines (TG13).
-
surgical treatment of patients with acute Cholecystitis tokyo guidelines
Journal of Hepato-biliary-pancreatic Surgery, 2007Co-Authors: Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Yoshifumi Kawarada, Yuji Nimura, Masahiko Hirota, Fumihiko Miura, Toshihiko Mayumi, Masahiro Yoshida, Henry A. PittAbstract:Cholecystectomy has been widely performed in the treatment of acute Cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute Cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute Cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute Cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute Cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute Cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute Cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute Cholecystitis in a question-and-answer format.
Toshihiko Mayumi - One of the best experts on this subject based on the ideXlab platform.
-
TG13 current terminology, etiology, and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-Biliary-Pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13). Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html .
-
tg13 current terminology etiology and epidemiology of acute cholangitis and Cholecystitis
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Yasutoshi Kimura, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Markus W. Büchler, John A. Windsor, Toshihiko Mayumi, James O Garden, Masahiro YoshidaAbstract:While referring to the evidence adopted in the Tokyo Guidelines 2007 (TG07) as well as subsequently obtained evidence, further discussion took place on terminology, etiology, and epidemiological data. In particular, new findings have accumulated on the occurrence of symptoms in patients with gallstones, frequency of severe Cholecystitis and cholangitis, onset of Cholecystitis and cholangitis after endoscopic retrograde cholangiopancreatography and medications, mortality rate, and recurrence rate. The primary etiology of acute cholangitis/Cholecystitis is the presence of stones. Next to stones, the most significant etiology of acute cholangitis is benign/malignant stenosis of the biliary tract. On the other hand, there is another type of acute Cholecystitis, acute acalculous Cholecystitis, in which stones are not involved as causative factors. Risk factors for acute acalculous Cholecystitis include surgery, trauma, burn, and parenteral nutrition. After 2000, the mortality rate of acute cholangitis has been about 10 %, while that of acute Cholecystitis has generally been less than 1 %. After the publication of TG07, diagnostic criteria and severity assessment criteria were standardized, and the distribution of cases according to severity and comparison of clinical data among target populations have become more subjective. The concept of healthcare-associated infections is important in the current treatment of infection. The treatment of acute cholangitis and Cholecystitis substantially differs from that of community-acquired infections. Cholangitis and Cholecystitis as healthcare-associated infections are clearly described in the updated Tokyo Guidelines (TG13).
-
new diagnostic criteria and severity assessment of acute Cholecystitis in revised tokyo guidelines
Journal of Hepato-biliary-pancreatic Sciences, 2012Co-Authors: Masamichi Yokoe, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, Harumi Gomi, Toshihiko Mayumi, James O Garden, Joseph S Solomkin, Markus W. BüchlerAbstract:Background The Tokyo Guidelines for the management of acute cholangitis and Cholecystitis (TG07) were published in 2007 as the world’s first guidelines for acute cholangitis and Cholecystitis. The diagnostic criteria and severity assessment of acute Cholecystitis have since been widely used all over the world. A validation study of TG07 has shown that the diagnostic criteria for acute Cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. In addition, considerable new evidence referring to acute Cholecystitis as well as evaluations of TG07 have been published. Consequently, we organized the Tokyo Guidelines Revision Committee to evaluate TG07, recognize new evidence, and conduct a multi-center analysis to revise the guidelines (TG13).
-
surgical treatment of patients with acute Cholecystitis tokyo guidelines
Journal of Hepato-biliary-pancreatic Surgery, 2007Co-Authors: Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Yoshifumi Kawarada, Yuji Nimura, Masahiko Hirota, Fumihiko Miura, Toshihiko Mayumi, Masahiro Yoshida, Henry A. PittAbstract:Cholecystectomy has been widely performed in the treatment of acute Cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute Cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute Cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute Cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute Cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute Cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute Cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute Cholecystitis in a question-and-answer format.
-
Background: Tokyo Guidelines for the management of acute cholangitis and Cholecystitis
Journal of Hepato-Biliary-Pancreatic Surgery, 2007Co-Authors: Tadahiro Takada, Yoshifumi Kawarada, Yuji Nimura, Masahiko Hirota, Fumihiko Miura, Toshihiko Mayumi, Masahiro Yoshida, Miho Sekimoto, Keita Wada, Yuichi YamashitaAbstract:There are no evidence-based-criteria for the diagnosis, severity assessment, of treatment of acute cholecysitis or acute cholangitis. For example, the full complement of symptoms and signs described as Charcot’s triad and as Reynolds’ pentad are infrequent and as such do not really assist the clinician with planning management strategies. In view of these factors, we launched a project to prepare evidence-based guidelines for the management of acute cholangitis and Cholecystitis that will be useful in the clinical setting. This research has been funded by the Japanese Ministry of Health, Labour, and Welfare, in cooperation with the Japanese Society for Abdominal Emergency Medicine, the Japan Biliary Association, and the Japanese Society of Hepato-Biliary-Pancreatic Surgery. A working group, consisting of 46 experts in gastroenterology, surgery, internal medicine, emergency medicine, intensive care, and clinical epidemiology, analyzed and examined the literature on patients with cholangitis and Cholecystitis in order to produce evidence-based guidelines. During the investigations we found that there was a lack of high-level evidence, for treatments, and the working group formulated the guidelines by obtaining consensus, based on evidence categorized by level, according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence of May 2001 (version 1). This work required more than 20 meetings to obtain a consensus on each item from the working group. Then four forums were held to permit examination of the Guideline details in Japan, both by an external assessment committee and by the working group participants (version 2). As we knew that the diagnosis and management of acute biliary infection may differ from country to country, we appointed a publication committee and held 12 meetings to prepare draft Guidelines in English (version 3). We then had several discussions on these draft guidelines with leading experts in the field throughout the world, via e-mail, leading to version 4. Finally, an International Consensus Meeting took place in Tokyo, on 1–2 April, 2006, to obtain international agreement on diagnostic criteria, severity assessment, and management.
