診断基準と重症度判定を用いた急性胆管炎・胆嚢炎の治療戦略 [in Japanese] Strategies for Acute Cholangitis and Acute Cholecystitis, Using the Diagnostic Criteria and Severity Assessment of the Japanese Evidenced-Based Guidelines [in Japanese]
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In September 2005, the world's first evidence-based guidelines for acute cholangitis and cholecystitis were published in Japan. We examine herein correlations between our clinical diagnosis and the guideline-based evaluations. The clinical records of 166 patients having an initial diagnosis of acute cholangitis, cholecystitis, obstructive jaundice or fever of unknown origin that were treated at Nagoya Daini Red Cross Hospital before publication of the guidelines were retrospectively examined. At the initial diagnosis there were 74 cases of acute cholangitis cases and 81 of cholecystitis, Cholangitis: Among the 74 cases in which the initial clinical diagnosis was cholangitis, the rate of definite diagnosis based on the diagnostic criteria was only 37.8%. However, if suspected diagnosis was included, the rate became 81.1%. On the other hand, there were 14 cases that did not meet the diagnostic criteria of acute cholangitis. Among these 14 cases, 4 cases (5.6%) met the criteria of acute cholecystitis. Cholecystitis: Among the 81 cases in which the initial clinical diagnosis was cholecystitis, the rate of definite diagnosis based on the diagnostic criteria was 67.9%. If suspected diagnosis was included, the rate became 82.7%. On the other hand, there were 14 cases that did not meet the diagnostic criteria of acute cholecystitis. Among these 14 cases, 4 cases (4.9%) met the criteria of acute cholangitis.
- Progress in Acute Abdominal Medicine
Progress in Acute Abdominal Medicine 28(3), 469-474, 2008-03-31
Japanese Society for Abdominal Emergency Medicine