Abstract
We evaluated the utility of the severity assessment criteria of the new JPN Guidelines (JPN13). We retrospectively studied 183 acute cholangitis (AC) cases with CBD stones that had been diagnosed as being of severe or moderate grade on the conventional JPN Guidelines (JPN05). Eleven severe cases [JPN05] were reorganized into 8 severe and 3 moderate cases of AC [JPN13]. 172 moderate cases [JPN05] were reorganized into 19 severe, 58 moderate and 95 mild cases [JPN13]. Ninety-five point eight percent of mild cases [JPN13] were moderate grade having one criterial factor in JPN05. On the other hand, 86.4% of severe cases [JPN13] were moderate grade having several criterial factors in JPN05. Between the moderate and mild group [JPN13] that had been reorganized from the moderate group [JPN05], a significant difference existed in the bilirubin level and positive rate of purulent bile. The wide range of the moderate group associated with overdiagnosis in JPN05 has been improved, it was considered useful to apply the severity assessment criteria in JPN13 for selecting the true adaptation cases for early drainage.
