Tokyo Guidelines Cholangitis Severity (TG18)
Classifies severity of acute cholangitis using the 2018 Tokyo Guidelines (TG18) to guide timing of biliary drainage and antibiotic therapy.
Score interpretation
No organ dysfunction and fewer than two Grade II criteria.
→ Antibiotics; most respond. Biliary drainage if there is no response within 24 hours; treat the cause (e.g. endoscopic stone removal, cholecystectomy) once settled.
Two or more of the Grade II criteria, no organ dysfunction.
→ Early biliary drainage (ERCP or PTBD) with IV antibiotics; monitor organ function; treat the cause once stable.
Dysfunction of at least one organ system.
→ Organ support (ICU); urgent biliary drainage (ERCP or PTBD) once stabilised; broad-spectrum antibiotics.
Interpretation bands for the TG18 Cholangitis. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Upper GI Bleeding · BSG Guidelines 2019; NICE NG141
- Lower Gastrointestinal Bleed · NICE; BSG; ACPGBI — Commissioning Guide
- Acute Pancreatitis · NICE; IAP/APA; ACPGBI — CG104
- Mushroom poisoning · TOXBASE/NPIS; AACT/EAPCCT; EASL
- Major Trauma — Primary Survey (ATLS) · ATLS 10th Edition; JRCALC; NICE NG39
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.
