This is divided into 4 parts

anatomy of extra-hepatic bile ducts

Causes of CBD stones

Medical Management

Surgical management



Acute cholangitis was first described by Charcot as hepatic fever in 18771. The diagnosis of acute cholangitis has been made based on Charcot's triad which was described as co-existence of

Charcot's Triad

1. Right upper quadrant pain

2. Jaundice

3. Fever

Tokyo Guidelines for management of Acute Cholangitis and cholecystitis was spublished in 2007 and revised criteria were published in year 2013.

Tyokyo Guidelines

(A) Systemic inflammation (A-1, fever and / or shaking shills), (A-2 laboratory data for inflammatory response)

(B) Cholestasis (B - 1, Jaundice, B - 2, abnormal liver function tests)

(C) Imaging (C - 1, Biliary dilatation, C -2, evidence of etiology on imaging, such as stricture, stone, stent, etc.)

existence of one item in A section with one item in B or C sections is referred to as suspected diagnosis, while existence of at least one item from each section is referred to as "Definitive diagnosis" 2.




  1. De la Charcot M (1877) Fievre hepatique symptomatique comparison avec la fievre uroseptique. Lecons sur les maladies du foie voies biliares et des reins. Bourneville et severstre, Paris.
  2. Kiriyama S, Takada T, Strasberg SM, et. al. (2013). TG13 guidelines for diagnosis and severity grading of acute cholangitis. J Hepatobiliary  Pancreastic sciences. 20, 24-24.
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