{"id":2179,"date":"2018-11-02T19:42:52","date_gmt":"2018-11-02T19:42:52","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=1343"},"modified":"2026-02-10T19:00:05","modified_gmt":"2026-02-10T19:00:05","slug":"cholangitis","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/cholangitis\/","title":{"rendered":"Criterios Diagn\u00f3stico TG18\/TG13 para Colangitis Aguda"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>El diagn\u00f3stico y los criterios de clasificaci\u00f3n de gravedad en las Gu\u00edas Tokio 2018 (TG18) se utilizan en todo el mundo como el est\u00e1ndar principal para el tratamiento de la colangitis aguda (CA).<\/p>\n<p><!--more--><\/p>\n<p><strong>Criterios Diagn\u00f3stico TG18\/TG13 para Colangitis Aguda<\/strong><\/p>\n<p>A. Inflamaci\u00f3n sist\u00e9mica.<br \/>\nA\u20101. Fiebre y\/o escalofr\u00edos<br \/>\nA\u20102. Datos de laboratorio: evidencia de respuesta inflamatoria.<\/p>\n<p>B. Colestasis<br \/>\nB\u20101. Ictericia<br \/>\nB\u20102. Datos de laboratorio: pruebas anormales de funci\u00f3n hep\u00e1tica.<\/p>\n<p>C. Im\u00e1genes<br \/>\nC\u20101. Dilataci\u00f3n biliar<br \/>\nC\u20102. Evidencia de la etiolog\u00eda en la imagen (estenosis, c\u00e1lculos, stent, etc.)<\/p>\n<p><strong>Sospecha diagn\u00f3stica:<\/strong> un \u00edtem en A + un \u00edtem en B o C<br \/>\n<strong>Diagn\u00f3stico definitivo:<\/strong> un \u00edtem en A, un \u00edtem en B y un \u00edtem en C<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Nota:<\/strong><\/p>\n<p>A\u20102: Recuentos anormales de gl\u00f3bulos blancos, aumento de los niveles s\u00e9ricos de prote\u00edna C-reactiva y otros cambios que indican inflamaci\u00f3n<\/p>\n<p>B\u20102: aumento de los niveles s\u00e9ricos de FAL, r-GTP (GGT), GOT y GPT<\/p>\n<p>Otros factores que son \u00fatiles para el diagn\u00f3stico de colangitis aguda incluyen dolor abdominal (cuadrante superior derecho o abdomen superior) y antecedentes de enfermedad biliar como c\u00e1lculos biliares, procedimientos biliares previos y colocaci\u00f3n de un stent biliar.<\/p>\n<p>En la hepatitis aguda, la respuesta inflamatoria sist\u00e9mica marcada se observa con poca frecuencia. Se requieren pruebas virol\u00f3gicas y serol\u00f3gicas cuando el diagn\u00f3stico diferencial es dif\u00edcil.<\/p>\n<p><strong>Umbrales:<\/strong><br \/>\nA\u20101 Fiebre: T\u00b0 &gt;38 \u00b0C<br \/>\nA\u20102 Evidencia de respuesta inflamatoria: recuento de leucocitos (\u00d7 1,000 \/ \u03bcL) &lt;4 o &gt;10; PCR (mg\/dL) \u22651<br \/>\nB\u20101 Ictericia: Bil-T\u00a0 \u22652 (mg\/dL)<br \/>\nB\u20102 Pruebas anormales de la funci\u00f3n hep\u00e1tica:<\/p>\n<ul>\n<li>FAL (UI) &gt; 1.5 \u00d7 LSN*<\/li>\n<li>\u03b3GTP (UI) &gt; 1.5 \u00d7 LSN*<\/li>\n<li>GOT (UI) &gt; 1.5 \u00d7 LSN*<\/li>\n<li>GPT (UI) &gt; 1.5 \u00d7 LSN*<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>Abreviaturas: FAL fosfatasa alcalina, GPT transaminasa glut\u00e1mico-pir\u00favica, GOT transaminasa glut\u00e1mico-oxalac\u00e9tica, PCR prote\u00edna\u00a0C reactiva, r-GTP (GGT) r-glutamiltransferasa, GB gl\u00f3bulos blancos.<\/p>\n<p>* LSN: l\u00edmite superior normal<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Kiriyama S, Kozaka K, Takada T, Strasberg SM, Pitt HA, Gabata T, Hata J, Liau KH, Miura F, Horiguchi A, Liu KH, Su CH, Wada K, Jagannath P, Itoi T, Gouma DJ, Mori Y, Mukai S, Gim\u00e9nez ME, Huang WS, Kim MH, Okamoto K, Belli G, Dervenis C, Chan ACW, Lau WY, Endo I, Gomi H, Yoshida M, Mayumi T, Baron TH, de Santiba\u00f1es E, Teoh AYB, Hwang TL, Ker CG, Chen MF, Han HS, Yoon YS, Choi IS, Yoon DS, Higuchi R, Kitano S, Inomata M, Deziel DJ, Jonas E, Hirata K, Sumiyama Y, Inui K, Yamamoto M.\u00a0Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos).\u00a0J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):17-30. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29032610\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, Kozaka K, Endo I, Deziel DJ, Miura F, Okamoto K, Hwang TL, Huang WS, Ker CG, Chen MF, Han HS, Yoon YS, Choi IS, Yoon DS, Noguchi Y, Shikata S, Ukai T, Higuchi R, Gabata T, Mori Y, Iwashita Y, Hibi T, Jagannath P, Jonas E, Liau KH, Dervenis C, Gouma DJ, Cherqui D, Belli G, Garden OJ, Gim\u00e9nez ME, de Santiba\u00f1es E, Suzuki K, Umezawa A, Supe AN, Pitt HA, Singh H, Chan ACW, Lau WY, Teoh AYB, Honda G, Sugioka A, Asai K, Gomi H, Itoi T, Kiriyama S, Yoshida M, Mayumi T, Matsumura N, Tokumura H, Kitano S, Hirata K, Inui K, Sumiyama Y, Yamamoto M.\u00a0Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos).\u00a0J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):41-54. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29032636\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Gravito-Soares E, Gravito-Soares M, Gomes D, Almeida N, Tom\u00e9 L. Clinical applicability of Tokyo guidelines 2018\/2013 in diagnosis and severity evaluation of acute cholangitis and determination of a new severity model.\u00a0Scand J Gastroenterol. 2018 Mar;53(3):329-334. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/29374984\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Smith SE. Management of Acute Cholangitis and Choledocholithiasis. Surg Clin North Am. 2024 Dec;104(6):1175-1189. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39448120\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Oct 19, 2018.<br \/>\nActualizado Feb 10, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>El diagn\u00f3stico y los criterios de clasificaci\u00f3n de gravedad en las Gu\u00edas Tokio 2018 (TG18) se utilizan en todo el mundo como el est\u00e1ndar principal para el tratamiento de la colangitis aguda (CA).<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[165],"tags":[231,230,376,375,16,15,14,13,377,225],"class_list":["post-2179","post","type-post","status-publish","format-standard","hentry","category-surgery","tag-acute","tag-aguda","tag-cholangitis","tag-colangitis","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-tg13","tag-tg18"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2179","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=2179"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2179\/revisions"}],"predecessor-version":[{"id":10654,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/2179\/revisions\/10654"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=2179"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=2179"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=2179"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}