The diagnostic and severity grading criteria on the 2018 Tokyo Guidelines (TG18) are used worldwide as the primary standard for management of acute cholangitis (AC). Continue reading
Bariatric surgery is usually considered when other weight loss efforts have failed. Eligibility criteria were established by the 1991 National Institutes of Health Consensus Development Conference Panel and continue to be the most widely accepted criteria.
Acute cholecystitis is a very common complication of cholelithiasis, and as such is frequently encountered in surgical practice. TG07 diagnostic criteria are recognized as those to be recommended in current care for acute cholecystitis.
The use of the Alvarado scoring system, which includes clinical examination findings and laboratory values, is helpful in ruling out appendicitis. Scores range from 1 to 10, with higher scores indicating a greater risk of appendicitis. When the score is less than 4, appendicitis is uncommon, and imaging and other interventions can be avoided.
- Recent history of acute biliary pancreatitis
- Recent history of jaundice
- Recent history of cholangitis
- Abnormal preoperative ultrasound demonstrating a dilated common bile duct or a defect (stone) in the common bile duct
- Evidence of common bile duct obstruction on hepatobiliary iminodiacetic acid scan (HIDA Scan)
- Increased serum bilirrubin
- Increased serum alkaline phophatase
- Increased serum amylase