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Volume 2022, Issue 4
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

Acute cholangitis (AC) is a life-threatening condition with a mortality risk of 8%–10%. Despite no gold standard for diagnosis, Charcot's triad was introduced to diagnose AC. However, the triad had a low sensitivity (50%–70%). Recently, Tokyo guidelines (TG) for the diagnosis of AC gained international recognition for their excellent diagnostic rate. In this study, we aimed to apply TG18 guidelines in a retrospective manner to diagnose AC in Qatar to validate TG18. This retrospective observational study recruited 295 patients with clinically proven AC between January 2016 and July 2018. Of the 213 patients, 72.2% were men. The mean age was 51.4 ± 17.5 years. The most common co-morbidity was hypertension (36.3%). Common bile duct stones were the most common cause of biliary obstruction found in 165 (55.9%) patients. The diagnostic rate of TG18 was 91.9% in contrast to Charcot's triad (34.9%). By TG18 grading, 150 (50.8%) patients were grade I. ERCP was done in 62% patients, and 52.5% of them were grade I. AC management in Qatar meets the international standards with a low mortality rate. TG18 guidelines had a high diagnostic rate among our patient population.

© 2022 Ghali, Al-Yahri, Al Dhaheri, Shah, Toffaha, Singh, Zarour, licensee HBKU Press.
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2022-07-18
2024-11-17
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/content/journals/10.5339/jemtac.2022.17
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Retrospective application and validation of Tokyo 18 guidelines for diagnosis and stratification of acute cholangitis in Qatar
Journal of Emergency Medicine, Trauma and Acute Care 2022, 17 (2022); https://doi.org/10.5339/jemtac.2022.17
/content/journals/10.5339/jemtac.2022.17
/content/journals/10.5339/jemtac.2022.17
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Keyword(s): acute cholangitis, Charcot's triad, mortality, TG18 and Tokyo guidelines (TG)

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