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Cholangitis
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All of the following features (as previously defined) [20]:
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1) Serum total bilirubin level >40 μmol/l (>2.3 mg/dl) and/or dilated common bile duct (>6 mm) on transabdominal or endoscopic ultrasound or computed tomography;
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2) Temperature >38.5°C.
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Organ failure
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Failure of one or more of the following organ systems [19]:
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1) Respiratory: PaO2 ≤60 mmHg or need for mechanical ventilation;
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2) Cardiovascular: systolic blood pressure <90 mmHg or need for catecholamine support;
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3) Renal: creatinine level >177 μmol/l after rehydration or need for hemofiltration or hemodialysis (not including pre-existent renal failure).
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Biliary leakage
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Defined according to the Amsterdam criteria [23]:
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Type A: cystic duct leaks or leakage from aberrant or peripheral hepatic radicals;
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Type B: major bile duct leaks with or without concomitant biliary strictures;
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Type C: bile duct strictures without bile leakage;
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Type D: complete transection of the duct with or without excision of some portion of the bile duct.
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