{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T04:36:49Z","timestamp":1793853409088,"version":"4.6.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,1,11]],"date-time":"2013-01-11T00:00:00Z","timestamp":1357862400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Since the publication of the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07), diagnostic criteria and severity assessment criteria for acute cholangitis have been presented and extensively used as the primary standard all over the world. However, it has been found that there are crucial limitations in these criteria. The diagnostic criteria of TG07 do not have enough sensitivity and specificity, and its severity assessment criteria are unsuitable for clinical use. A working team for the revision of TG07 was organized in June, 2010, and these criteria have been updated through clinical implementation and its assessment by means of multi\u2010center analysis. The diagnostic criteria of acute cholangitis have been revised as criteria to establish the diagnosis where cholestasis and inflammation demonstrated by clinical signs or blood test in addition to biliary manifestations demonstrated by imaging are present. The diagnostic criteria of the updated Tokyo Guidelines (TG13) have high sensitivity (87.6 %) and high specificity (77.7 %). TG13 has better diagnostic capacity than TG07. Severity assessment is classified as follows: Grade III: associated with organ failure; Grade II: early biliary drainage should be conducted; Grade1: others. As for the severity assessment criteria of TG07, separating Grade II and Grade I at the time of diagnosis was impossible, so they were unsuitable for clinical practice. Therefore, the severity assessment criteria of TG13 have been revised so as not to lose the timing of biliary drainage or treatment for etiology. Based on evidence, five predictive factors for poor prognosis in acute cholangitis\u2014hyperbilirubinemia, high fever, leukocytosis, elderly patient and hypoalbuminemia\u2014have been extracted. Grade II can be diagnosed if two of these five factors are present.<\/jats:p>","DOI":"10.1007\/s00534-012-0561-3","type":"journal-article","created":{"date-parts":[[2013,1,10]],"date-time":"2013-01-10T16:36:22Z","timestamp":1357835782000},"page":"24-34","source":"Crossref","is-referenced-by-count":233,"title":["TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos)"],"prefix":"10.1002","volume":"20","author":[{"given":"Seiki","family":"Kiriyama","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Ogaki Municipal Hospital  4\u201086 Minaminokawa\u2010cho Ogaki Gifu 503\u20108502 Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadahiro","family":"Takada","sequence":"additional","affiliation":[{"name":"Department of Surgery Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Strasberg","sequence":"additional","affiliation":[{"name":"Section of Hepatobiliary and Pancreatic Surgery Washington University in Saint Louis School of Medicine  Saint Louis MO USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph S.","family":"Solomkin","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Cincinnati College of Medicine  Cincinnati OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Mayumi","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Ichinomiya Municipal Hospital  Ichinomiya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry A.","family":"Pitt","sequence":"additional","affiliation":[{"name":"Department of Surgery Indiana University School of Medicine  Indianapolis IN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk J.","family":"Gouma","sequence":"additional","affiliation":[{"name":"Department of Surgery Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. James","family":"Garden","sequence":"additional","affiliation":[{"name":"Clinical Surgery The University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus W.","family":"B\u00fcchler","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masamichi","family":"Yokoe","sequence":"additional","affiliation":[{"name":"General Internal Medicine Nagoya Daini Red Cross Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutoshi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology and Gastroenterological Surgery Sapporo Medical University School of Medicine  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Tsuyuguchi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Oncology Graduate School of Medicine Chiba University  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Itoi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Clinical Research Center Kaken Hospital International University of Health and Welfare  Ichikawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiko","family":"Miura","sequence":"additional","affiliation":[{"name":"Department of Surgery Teikyo University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Fukuoka University School of Medicine  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohji","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Department of Surgery Kitakyushu Municipal Yahata Hospital  Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshifumi","family":"Gabata","sequence":"additional","affiliation":[{"name":"Department of Radiology Kanazawa University Graduate School of Medical Science  Kanazawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Hata","sequence":"additional","affiliation":[{"name":"Department of Endoscopy and Ultrasound Kawasaki Medical School  Okayama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Surgery Institute of Gastroenterology Tokyo Women's Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Windsor","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippus C.","family":"Bornman","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Health Sciences University of Cape Town  Cape Town South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheung\u2010Tat","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Hong Kong, Queen Mary Hospital  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harijt","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Hepato\u2010Pancreato\u2010Biliary Surgery Hospital Selayang  Kuala Lampur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"de Santibanes","sequence":"additional","affiliation":[{"name":"Department of Surgery Hospital Italianio, University of Buenos Aires  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harumi","family":"Gomi","sequence":"additional","affiliation":[{"name":"Center for Clinical Infectious Diseases Jichi Medical University  Tochigi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Kusachi","sequence":"additional","affiliation":[{"name":"Department of Surgery Toho University Medical Center Ohashi Hospital  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuhiko","family":"Murata","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Community Health, School of Medicine University of Occupational and Environmental Health  Kitakyushu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao\u2010Ping","family":"Chen","sequence":"additional","affiliation":[{"name":"Hepatic Surgery Centre, Department of Surgery, Tongji Hospital Tongi Medical College, Huazhong University of Science and Technology  Wuhan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Palepu","family":"Jagannath","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology Lilavati Hospital and Research Centre  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Gyu","family":"Lee","sequence":"additional","affiliation":[{"name":"HepatoBiliary Surgery and Liver Transplantation Asan Medical Center, Ulsan University  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Padbury","sequence":"additional","affiliation":[{"name":"Division of Surgical and Specialty Services Flinders Medical Centre  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miin\u2010Fu","family":"Chen","sequence":"additional","affiliation":[{"name":"Chang Gung Memorial Hospital Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Dervenis","sequence":"additional","affiliation":[{"name":"First Department of Surgery Agia Olga Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angus C.W.","family":"Chan","sequence":"additional","affiliation":[{"name":"Surgery Centre, Department of Surgery Hong Kong Sanatorium and Hospital  Hong Kong Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avinash N.","family":"Supe","sequence":"additional","affiliation":[{"name":"Department of Surgical Gastroenterology Seth G. S. Medical College and K. E. M. Hospital  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kui\u2010Hin","family":"Liau","sequence":"additional","affiliation":[{"name":"Hepatobiliary and Pancreatic Surgery, Nexus Surgical Associates Mount Elizabeth Hospital  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myung\u2010Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center University of Ulsan  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sun\u2010Whe","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Surgery Seoul National University College of Medicine  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,1,11]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196902000-00015"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(76)90003-9"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198003000-00002"},{"key":"e_1_2_3_5_1","first-page":"369","article-title":"Clinical management of acute cholangitis","volume":"142","author":"Saharia PC","year":"1976","journal-title":"Surg Gynecol Obstet."},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01656040"},{"key":"e_1_2_3_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-006-1156-7"},{"key":"e_1_2_3_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-010-0338-5"},{"key":"e_1_2_3_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-012-0537-3"},{"key":"e_1_2_3_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800790720"},{"key":"e_1_2_3_11_1","doi-asserted-by":"publisher","DOI":"10.1155\/1994\/73139"},{"key":"e_1_2_3_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198904000-00008"},{"key":"e_1_2_3_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1982.01380280031007"},{"key":"e_1_2_3_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-199001000-00009"},{"key":"e_1_2_3_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1967.01330100024004"},{"key":"e_1_2_3_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-006-1150-0"},{"key":"e_1_2_3_17_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.181.1.1810115"},{"key":"e_1_2_3_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-008-9445-z"},{"key":"e_1_2_3_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2007.11.031"},{"key":"e_1_2_3_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0730-725X(01)00401-5"},{"key":"e_1_2_3_21_1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.297095051"},{"key":"e_1_2_3_22_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.135.4.735"},{"key":"e_1_2_3_23_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.142.5.941"},{"key":"e_1_2_3_24_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.154.3.3969480"},{"key":"e_1_2_3_25_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.176.3.1760675"},{"key":"e_1_2_3_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2001.04045.x"},{"key":"e_1_2_3_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(97)00022-6"},{"key":"e_1_2_3_28_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.207.1.9530295"},{"key":"e_1_2_3_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-2586(199902)9:2<285::AID-JMRI20>3.0.CO;2-S"},{"key":"e_1_2_3_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2008.03.001"},{"key":"e_1_2_3_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199206113262401"},{"key":"e_1_2_3_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(89)92696-2"},{"key":"e_1_2_3_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-012-0538-2"}],"container-title":["Journal of Hepato-Biliary-Pancreatic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1007%2Fs00534-012-0561-3","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00534-012-0561-3","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,12]],"date-time":"2023-09-12T22:03:51Z","timestamp":1694556231000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00534-012-0561-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,1]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1007\/s00534-012-0561-3"],"URL":"https:\/\/doi.org\/10.1007\/s00534-012-0561-3","archive":["Portico"],"relation":{},"ISSN":["1868-6974","1868-6982"],"issn-type":[{"value":"1868-6974","type":"print"},{"value":"1868-6982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1]]}}}