{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T03:44:36Z","timestamp":1770522276210,"version":"3.49.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Purpose<\/jats:title><jats:p>The aim of this study was to clarify the clinical characteristics of acute cholangitis (AC) after bilioenteric anastomosis and stent\u2010related AC in a multi\u2010institutional retrospective study, and validate the TG18 diagnostic performance for various type of cholangitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed 1079 AC patients during 2020, at 16 Tokyo Guidelines 18 (TG 18) Core Meeting institutions. Of these, the post\u2010biliary reconstruction associated AC (PBR\u2010AC), stent\u2010associated AC (S\u2010AC) and common AC (C\u2010AC) were 228, 307, and 544, respectively. The characteristics of each AC were compared, and the TG18 diagnostic performance of each was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The PBR\u2010AC group showed significantly milder biliary stasis compared to the C\u2010AC group. Using TG18 criteria, definitive diagnosis rate in the PBR\u2010AC group was significantly lower than that in the C\u2010AC group (59.6% vs. 79.6%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) because of significantly lower prevalence of TG 18 imaging findings and milder bile stasis. In the S\u2010AC group, the bile stasis was also milder, but definitive\u2010diagnostic rate was significantly higher (95.1%) compared to the C\u2010AC group. The incidence of transient hepatic attenuation difference (THAD) and pneumobilia were more frequent in PBR\u2010AC than that in C\u2010AC. The definitive\u2010diagnostic rate of PBR\u2010AC (59.6%\u201378.1%) and total cohort (79.6%\u201385.3%) were significantly improved when newly adding these items to TG18 diagnostic imaging findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The diagnostic rate of PBR\u2010AC using TG18 is low, but adding THAD and pneumobilia to TG imaging criteria may improve TG diagnostic performance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1368","type":"journal-article","created":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T11:40:55Z","timestamp":1698320455000},"page":"12-24","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A multi\u2010institutional study designed by members of Tokyo Guidelines (<scp>TG<\/scp>) Core Meeting to elucidate the clinical characteristics and pathogenesis of acute cholangitis after bilioenteric anastomosis and biliary stent insertion with a focus on biliary obstruction: Role of transient hepatic attenuation difference (<scp>THAD<\/scp>) and pneumobilia in improving <scp>TG<\/scp> diagnostic performance"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5798-2725","authenticated-orcid":false,"given":"Hiroyuki","family":"Kato","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery Fujita Health University Bantane Hospital  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4023-6793","authenticated-orcid":false,"given":"Tadahiro","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Surgery Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Strasberg","sequence":"additional","affiliation":[{"name":"Section of Hepatobiliary\u2010Pancreatic and GI Surgery Washington University  St. Louis Missouri 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of Hepato\u2010Biliary\u2010Pancreatic Surgery and Transplantation Kanazawa University  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9883-1018","authenticated-orcid":false,"given":"Takashi","family":"Matsubara","sequence":"additional","affiliation":[{"name":"Department of Radiology Kanazawa University Graduate School of Medical Sciences  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2423-4154","authenticated-orcid":false,"given":"Ryota","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuji","family":"Ohyama","sequence":"additional","affiliation":[{"name":"Biostatistics Center Kurume University  Kurume 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