Poster ‐ Gastroenterology
Abstract
Background and Aim: We evaluate the severity assessment criteria for acute cholangitis (AC) of the Tokyo Guidelines 2013 (TG13) and developed a scoring system for predicting the need for urgent/early biliary drainage.Methods: We retrospectively reviewed 66 consecutive AC cases (M:F = 39:27, average age 72 years) prospectively managed based on the TG07 and divided into an urgent/early biliary drainage group (n = 30) and elective biliary drainage group (n = 36). Results:(1) There were 26 mild cases, 27 moderate cases, and 13 severe cases in AC based on the TG13.TG13 assessment in 12 of the 17 cases requiring early biliary drainage based on the TG07 was moderate AC but underestimated the other five cases as mild AC.(2) When five predictors were used to devise a scoring system (maximum score possible: 8 points) in which 2 points each were assigned for BUN >20 mg/dL, the presence of SIRS and a platelet count <120 000/μL, which were identified by multivariate analysis as statistically significant factors and 1 point each for serum albumin <3.0 g/dL and age ≧75 years, which were identified by univariate analysis alone as statistically significant factors, the receiveroperator characteristic curve of the scores showed good test performance for predicting the need for urgent/early biliary drainage.The area under the curve (AUC) of the score was 0.95 and statistically significantly higher than the TG13 AUC (0.80) (P = 0.004).Conclusions: The TG13 is practical, but some AC cases…
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