ReviewJournal of clinical medicine2023
Early Management of Severe Biliary Infection in the Era of the Tokyo Guidelines.
Review in Journal of clinical medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 22 citations in OpenAlex.
- Explainable early prediction of short-term severe deterioration in gallstone-related biliary disease using MIMIC-IV, eICU, and local real-world data.BMC gastroenterology · 2026Article
- Biliary Microbiota in Health and Disease: Clinical Implications in Lithiasis, Infection, and Antimicrobial Resistance.Antibiotics (Basel, Switzerland) · 2026Review
- Evolution of gallbladder drainage: a comprehensive review from percutaneous to endoscopic ultrasound-guided approaches.Journal of gastroenterology · 2026Article
- Timing of intervention: Assessing earlyWorld journal of gastrointestinal endoscopy · 2026Article
- Predictive Value of the Neutrophil‒Lymphocyte Ratio in the Risk Stratification and Prognosis for Patients with Acute Cholangitis: A Single-Center Retrospective Study.Journal of inflammation research · 2026Article
- Emergency Department Disposition and Point-of-Care Ultrasound in Biliary Disease: Propensity-Weighted Cohort Study.The western journal of emergency medicine · 2025Article
- Point-of-Care Testing and Biomarkers in Biliary Diseases: Current Evidence and Future Directions.Journal of clinical medicine · 2025Review
- Cholecystectomy in the Context of Cirrhosis, Sclero-Atrophic Cholecystitis, and Gangrenous Cholecystitis: A Literature Review.Medicina (Kaunas, Lithuania) · 2025Review
- Optimization of meropenem dosing regimens in critically ill patients with augmented renal clearance.Frontiers in medicine · 2025Article
- Updates on Antibiotic Regimens in Acute Cholecystitis.Medicina (Kaunas, Lithuania) · 2024Review
- Clinical Utility of the Tokyo Guidelines 2018 for Acute Cholangitis in the Emergency Department and Comparison with Novel Markers (Neutrophil-to-Lymphocyte and Blood Nitrogen Urea-to-Albumin Ratios).Journal of clinical medicine · 2024Article
- Intrahepatic aneurysm in a branch of the right hepatic artery in a patient with vasculitis due to systemic lupus erythematosus.Przeglad gastroenterologiczny · 2024Article
- The Comparison of Clinical Outcomes in Elderly (≥75 Years) and Non-Elderly (<75 Years) Patients with Acute Cholangitis Due to Choledocholithiasis.Medicina (Kaunas, Lithuania) · 2023Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Sepsis of biliary origin is increasing worldwide and has become one of the leading causes of emergency department admissions. The presence of multi-resistant bacteria (MRB) is increasing, and mortality rates may reach 20%. This review focuses on the changes induced by the Tokyo guidelines and new concepts related to the early treatment of severe biliary disease. If cholecystitis or cholangitis is suspected, ultrasound is the imaging test of choice. Appropriate empirical antibiotic treatment should be initiated promptly, and selection should be performed while bearing in mind the severity and risk factors for MRB. In acute cholecystitis, laparoscopic cholecystectomy is the main therapeutic intervention. In patients not suitable for surgery, percutaneous cholecystostomy is a valid alternative for controlling the infection. Treatment of severe acute cholangitis is based on endoscopic or transhepatic bile duct drainage and antibiotic therapy. Endoscopic ultrasound and other new endoscopic techniques have been added to the arsenal as novel alternatives in high-risk patients. However, biliary infections remain serious conditions that can lead to sepsis and death. The introduction of internationally accepted guidelines, based on clinical presentation, laboratory tests, and imaging, provides a framework for their rapid diagnosis and treatment. Prompt assessment of patient severity, timely initiation of antimicrobials, and early control of the source of infection are essential to reduce morbidity and mortality rates.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.