TG13: Updated Tokyo Guide lines for acute cholangitis and

acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
 Patofisiología
Formación del
Lito

Taponamiento
del cuello o el
conducto cístico.

Inflamación

Grado de
Taponamient
Duración de la
o
obstrucción
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
 USG: 50-88% S y 80-88 E.

a.Engrosamiento de la pared vesicular > 5

mm
b. Fluido pericolecistico.
c. Signo de Murphy USG
D. Cálculos
E. Gas vesicular.

TG13: Updated Tokyo Guide lines for acute cholangitis and

acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
Lawrence M. Knab et al..
Cholecystitis
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
 Colecistitis enfisematosa
1. Engrosamiento irregular de la pared vesicular.
2. Imagen sugestiva de ruptura de la pared
.

3. Eco producido por el gas

TG13: Updated Tokyo Guide lines for acute cholangitis and

acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
Tomado de: Bile Duct Strictures. R Brugge et
al
TG13: Updated Tokyo Guide lines for acute
cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
Triada de Charcot: Baja S (26,4%), alta
E (95,9). 26-72% de todos los
pacientes.

TG13: Updated Tokyo Guide lines for acute cholangitis and

acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
6. Disfunción Hematológica.
7. Trastorno de la conciencia.
8. Indice Kirby < 300
9. Oliguria, Creatinina > 2 mg/dl
10. PT/INR > 1,5
11.Conteo plaquetario: < 100
000.
12.hipotensión refractaria a
medicamentos.
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
Grado I (Colecistitis o Colangitis): Cefotaxim + Metronidazol.
1 día de AB post Colecistectomía
Perforación, enfisematosa, 2-7 días post colecistectomía. (Colecistitis).
Colangitis: 4-7 días, bacteremia Gram + 2 semanas.

Grado II (Colecistitis o Colangitis): Cefepime, ceftazidima + metronizaol o Piperacilina tazobactan.

4-7 días, bacteremia Gram + 2 semanas.

Grado III (Colecistitis o Colangitis): Cefepime, ceftazidima + metronizaol, Piperacilna/tazobactan.

4-7 días, bacteremia Gram + 2 semanas.
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
TG13: Updated Tokyo Guide lines for acute cholangitis and
acute cholecystitis.
J Hepatobiliary Pancreat
Gracias