Study on Treatment of Moderate Acutecholangitis in Guidelines

Abstract

It is noteworthy that the guidelines for acute cholangitis and cholecystitis based on scientific evidence (JGL) have improved the management of acute cholangitis and cholecystitis. However, they have also revealed some problems, one of which may be that many cases are moderate under the current classification. A univariate analysis of the criteria showed a significant difference between renal dysfunction and high grade fever, and high grade fever was selected with a multivariate analysis. Despite urgent biliary drainage, cases that had high grade fever demonstrated prolonged symptoms, so it was suggested that they should be treated as equivalent to severe cases. In addition, the Tokyo Guidelines (TGL) showed a 26% correspondence with moderate under the JGL guidelines with a fasting period of 3.5 days, demonstrating a large difference between them. In the multivariate analysis, even moderate hyperthermia was not selected, the TGL was considered an issue that could not be determined at the time of the first visit.