Abstract
It has been 5 years since the publication of the Japanese Evidenced-Based Guidelines for Acute Cholangitis and Acute Cholecystitis, and it is time to verify the accuracy of the diagnostic criteria, etc. In this study we used 74 initial diagnosis cases of acute cholangitis and 81 initial diagnosis cases of acute cholecystitis to verify the diagnostic accuracy of the diagnostic criteria in the Japanese Evidenced-Based Guidelines for Acute Cholangitis and Acute Cholecystitis. The results for suspected diagnosis and definite diagnosis in the acute cholangitis cases showed that the diagnostic criteria had a sensitivity of 83.6% and a specificity of 30.7%, and for definite diagnosis alone they had a sensitivity of 45.9% and a specificity of 84.6%. The results for suspected diagnosis and definite diagnosis in the acute cholecystitis cases showed a sensitivity of 89.0% and specificity of 37.5%, and for definite diagnosis alone they had a sensitivity of 72.6% and specificity of 62.5%. The Charcot triad and the Murphy sign both had high specificity and were useful for making a definite diagnosis, but they were found not to be useful for exclusion because of their low sensitivity. From the standpoint of picking up cases it will be necessary to maintain the high sensitivity of the diagnostic criteria in the Japanese Evidenced-Based Guidelines for Acute Cholangitis and Acute Cholecystitis, and from the standpoint of making definite diagnoses it will be necessary to strive for higher specificity when revising them.
