@article{hbkup:/content/journals/10.5339/jemtac.2022.17, author = "Said Ghali, Mohamed and Al-Yahri, Omer and Al Dhaheri, Mahmood and Ali Shah, Amjad and Toffaha, Ali and Singh, Rajvir and Zarour, Ahmad", title = "Retrospective application and validation of Tokyo 18 guidelines for diagnosis and stratification of acute cholangitis in Qatar", journal= "Journal of Emergency Medicine, Trauma and Acute Care", year = "2022", volume = "2022", number = "4", pages = "", doi = "https://doi.org/10.5339/jemtac.2022.17", url = "https://www.qscience.com/content/journals/10.5339/jemtac.2022.17", publisher = "Hamad bin Khalifa University Press (HBKU Press)", issn = "1999-7094", type = "Journal Article", keywords = "Charcot's triad", keywords = "acute cholangitis", keywords = "Tokyo guidelines (TG)", keywords = "TG18", keywords = "mortality", eid = "17", abstract = "Background: Acute cholangitis (AC) is a life-threatening condition with a mortality risk of 8%–10%. Despite no gold standard for diagnosis, Charcot's triad was introduced to diagnose AC. However, the triad had a low sensitivity (50%–70%). Recently, Tokyo guidelines (TG) for the diagnosis of AC gained international recognition for their excellent diagnostic rate. Objective: In this study, we aimed to apply TG18 guidelines in a retrospective manner to diagnose AC in Qatar to validate TG18. Methods: This retrospective observational study recruited 295 patients with clinically proven AC between January 2016 and July 2018. Results: Of the 213 patients, 72.2% were men. The mean age was 51.4 ± 17.5 years. The most common co-morbidity was hypertension (36.3%). Common bile duct stones were the most common cause of biliary obstruction found in 165 (55.9%) patients. The diagnostic rate of TG18 was 91.9% in contrast to Charcot's triad (34.9%). By TG18 grading, 150 (50.8%) patients were grade I. ERCP was done in 62% patients, and 52.5% of them were grade I. Conclusion: AC management in Qatar meets the international standards with a low mortality rate. TG18 guidelines had a high diagnostic rate among our patient population.", }