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001-es BibID:	BIBFORM113578
035-os BibID:	(Scopus)85165616258
Első szerző:	Juhász Márk Félix
Cím:	Invalidity of Tokyo guidelines in acute biliary pancreatitis : A multicenter cohort analysis of 944 pancreatitis cases / Juhász Márk Félix, Tóháti Rebeka, Jászai Viktória Adrienn, Molnár Regina, Farkas Nelli, Czakó László, Vincze Áron, Erőss Bálint, Szentesi Andrea, Izbéki Ferenc, Papp Mária, Hegyi Péter, Párniczky Andrea, Hungarian Pancreatic Study Group
Dátum:	2023
ISSN:	2050-6406 2050-6414
Megjegyzések:	Abstract Background There is a noteworthy overlap between the clinical picture of biliary acute pancreatitis (AP) and the 2018 Tokyo guidelines currently used for the diagnosis of cholangitis (AC) and cholecystitis (CC). This can lead to significant antibiotic and endoscopic retrograde cholangiopancreatography (ERCP) overuse. Objectives We aimed to assess the on-admission prevalence of AC/CC according to the 2018 Tokyo guidelines (TG18) in a cohort of biliary AP patients, and its association with antibiotic use, ERCP and clinically relevant endpoints. Methods We conducted a secondary analysis of the Hungarian Pancreatic Study Group's prospective multicenter registry of 2195 AP cases. We grouped and compared biliary cases (n?=?944) based on the on-admission fulfillment of definite AC/CC according to TG18. Aside from antibiotic use, we evaluated mortality, AC/CC/AP severity, ERCP performance and length of hospitalization. We also conducted a literature review discussing each criteria of the TG18 in the context of AP. Results 27.8% of biliary AP cases fulfilled TG18 for both AC and CC, 22.5% for CC only and 20.8% for AC only. Antibiotic use was high (77.4%). About 2/3 of the AC/CC cases were mild, around 10% severe. Mortality was below 1% in mild and moderate AC/CC patients, but considerably higher in severe cases (12.8% and 21.2% in AC and CC). ERCP was performed in 89.3% of AC cases, common bile duct stones were found in 41.1%. Conclusion Around 70% of biliary AP patients fulfilled the TG18 for AC/CC, associated with a high rate of antibiotic use. Mortality in presumed mild or moderate AC/CC is low. Each of the laboratory and clinical criteria are commonly fulfilled in biliary AP, single imaging findings are also unspecific?AP specific diagnostic criteria are needed, as the prevalence of AC/CC are likely greatly overestimated. Randomized trials testing antibiotic use are also warranted.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	United European Gastroenterology Journal. - 11 (2023), p. 767-774. -
További szerzők:	Tóháti Rebeka Jászai Viktória Adrienn Molnár Regina Farkas Nelli Czakó László Vincze Áron Erőss Bálint Szentesi Andrea Izbéki Ferenc Papp Mária (1975-) (belgyógyász, gasztroenterológus) Hegyi Péter Jenő (belgyógyász) Párniczky Andrea (gyermekgyógyász) Hungarian Pancreatic Study Group
Pályázati támogatás:	FK138929 OTKA
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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