Acute Cholangitis Diagnosis (Tokyo Guidelines TG18)
Acute cholangitis diagnosis (Tokyo Guidelines TG18/TG13, Kiriyama 2018): classifies a presentation as definite, suspected, or not-met from three categories.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- A-1 fever and/or shaking chills
- Yes
- B-1 jaundice
- Yes
Result: Suspected acute cholangitis (TG18): one item in category A (fever) plus one in B (jaundice); a definite diagnosis needs one item in each of A, B, and C.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Suspected
- One item in A (systemic inflammation) plus one item in either B (cholestasis) or C (imaging).
- Definite
- One item in each of A, B, and C.
- Not met
- Fewer items than the suspected threshold; the presentation does not meet TG18 criteria.
What you enter
- A-1 fever and/or shaking chills (BT > 38 C)
- A-2 lab evidence of inflammatory response (WBC < 4 or > 10 x1000/uL, or CRP >= 1 mg/dL)
- B-1 jaundice (total bilirubin >= 2 mg/dL)
- B-2 abnormal liver function tests (ALP, GGT, AST, or ALT > 1.5x upper limit of normal)
- C-1 biliary dilatation on imaging
- C-2 evidence of the etiology on imaging (stricture, stone, stent, etc.)
How this is calculated
Miura F, Okamoto K, Takada T, et al. Tokyo Guidelines 2018: initial management of acute biliary infection and flowchart for acute cholangitis. J Hepatobiliary Pancreat Sci. 2018;25(1):31-40 (Table 1, cited from Kiriyama et al.). Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.