A multi-institutional study designed by members of Tokyo Guidelines (TG) 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 (THAD) and pneumobilia in improving TG diagnostic performance

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2023-10-26 DOI:10.1002/jhbp.1368

Hiroyuki Kato, Tadahiro Takada, Steven Strasberg, Shuji Isaji, Keiji Sano, Masahiro Yoshida, Takao Itoi, Kohji Okamoto, Seiki Kiriyama, Shintaro Yagi, Takashi Matsubara, Ryota Higuchi, Tetsuji Ohyama, Takeyuki Misawa, Shuntaro Mukai, Yasuhisa Mori, Koji Asai, Shugo Mizuno, Yuta Abe, Kenji Suzuki, Yuki Homma, Jiro Hata, Kana Tsukiyama, Yusuke Kumamoto, Toshio Tsuyuguchi, Hirotoshi Maruo, Yukio Asano, Shutaro Hori, Makoto Shibuya, Toshihiko Mayumi, Naoyuki Toyota, Akiko Umezawa, Harumi Gomi, Akihiko Horiguchi

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引用次数: 0

Abstract

Background/Purpose

The aim of this study was to clarify the clinical characteristics of acute cholangitis (AC) after bilioenteric anastomosis and stent-related AC in a multi-institutional retrospective study, and validate the TG18 diagnostic performance for various type of cholangitis.

Methods

We retrospectively reviewed 1079 AC patients during 2020, at 16 Tokyo Guidelines 18 (TG 18) Core Meeting institutions. Of these, the post-biliary reconstruction associated AC (PBR-AC), stent-associated AC (S-AC) and common AC (C-AC) were 228, 307, and 544, respectively. The characteristics of each AC were compared, and the TG18 diagnostic performance of each was evaluated.

Results

The PBR-AC group showed significantly milder biliary stasis compared to the C-AC group. Using TG18 criteria, definitive diagnosis rate in the PBR-AC group was significantly lower than that in the C-AC group (59.6% vs. 79.6%, p < .001) because of significantly lower prevalence of TG 18 imaging findings and milder bile stasis. In the S-AC group, the bile stasis was also milder, but definitive-diagnostic rate was significantly higher (95.1%) compared to the C-AC group. The incidence of transient hepatic attenuation difference (THAD) and pneumobilia were more frequent in PBR-AC than that in C-AC. The definitive-diagnostic rate of PBR-AC (59.6%–78.1%) and total cohort (79.6%–85.3%) were significantly improved when newly adding these items to TG18 diagnostic imaging findings.

Conclusions

The diagnostic rate of PBR-AC using TG18 is low, but adding THAD and pneumobilia to TG imaging criteria may improve TG diagnostic performance.

Abstract Image

查看原文本刊更多论文

由东京指南（TG）核心会议成员设计的一项多机构研究，旨在阐明胆肠吻合术和胆道支架置入后急性胆管炎的临床特征和发病机制，重点关注胆道梗阻：短暂性肝衰减差异（THAD）和胆汁积气在提高TG诊断性能中的作用。

背景/目的：本研究的目的是在一项多机构回顾性研究中阐明胆肠吻合术后急性胆管炎（AC）和支架相关AC的临床特征，并验证TG18对各种类型胆管炎的诊断性能。方法：我们回顾性回顾了2020年在16个东京指南18（TG 18）核心会议机构的1079名AC患者。其中，胆道重建后相关AC（PBR-AC）、支架相关AC（S-AC）和普通AC（C-AC）分别为228、307和544。比较了每种AC的特征，并评估了每种的TG18诊断性能。结果：与C-AC组相比，PBR-AC组表现出明显较轻的胆汁淤积。使用TG18标准，PBR-AC组的最终诊断率显著低于C-AC组（59.6%对79.6%，p 结论：TG18对PBR-AC的诊断率较低，但在TG成像标准中加入THAD和肺活量可提高TG的诊断性能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.