Year: 2017
Type: article
Abstract: We propose a new flowchart for the treatment of acute cholecystitis (AC) in the Tokyo Guidelines 2018 (TG18). Grade III AC was not indicated for straightforward laparoscopic cholecystectomy (Lap-C). Following analysis of subsequent clinical investigations and drawing on Big Data in particular, TG18 proposes that some Grade III AC can be treated by Lap-C when performed at advanced centers with specialized surgeons experienced in this procedure and for patients that satisfy certain strict criteria. For Grade I, TG18 recommends early Lap-C if the patients meet the criteria of Charlson comorbidity index (CCI) ≤5 and American Society of Anesthesiologists physical status classification (ASA-PS) ≤2. For Grade II AC, if patients meet the criteria of CCI ≤5 and ASA-PS ≤2, TG18 recommends early Lap-C performed by experienced surgeons; and if not, after medical treatment and/or gallbladder drainage, Lap-C would be indicated. TG18 proposes that Lap-C is indicated in Grade III patients with strict criteria. These are that the patients have favorable organ system failure, and negative predictive factors, who meet the criteria of CCI ≤3 and ASA-PS ≤2 and who are being treated at an advanced center (where experienced surgeons practice). If the patient is not considered suitable for early surgery, TG18 recommends early/urgent biliary drainage followed by delayed Lap-C once the patient's overall condition has improved. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.
DOI: 10.1002/jhbp.516
Authors: Kohji Okamoto, Kenji Suzuki, Tadahiro Takada, Steven M. Strasberg, Horacio J. Asbun, Itaru Endo, Yukio Iwashita, Taizo Hibi, Henry A. Pitt, Akiko Umezawa, Koji Asai, Ho‐Seong Han, Tsann‐Long Hwang, Yasuhisa Mori, Yoo‐Seok Yoon, Wayne Shih‐Wei Huang, Giulio Belli, Christos Dervenis, Masamichi Yokoe, Seiki Kiriyama, Takao Itoi, Palepu Jagannath, O. James Garden, Fumihiko Miura, Masafumi Nakamura, Akihiko Horiguchi, Go Wakabayashi, Daniel Cherqui, Eduardo de Santibañes, Satoru Shikata, Yoshinori Noguchi, Tomohiko Ukai, Ryota Higuchi, Keita Wada, Goro Honda, Avinash Nivritti Supe, Masahiro Yoshida, Toshihiko Mayumi, Dirk J. Gouma, Daniel J. Deziel, Kui‐Hin Liau, Miin‐Fu Chen, Kazunori Shibao, Keng‐Hao Liu, Cheng‐Hsi Su, Angus C. W. Chan, Dong‐Sup Yoon, In‐Seok Choi, Eduard Jonas, Xiao‐Ping Chen, Sheung Tat Fan, Chen‐Guo Ker, Mariano Eduardo Giménez, Seigo Kitano, Masafumi Inomata, Koichi Hirata, Kazuo Inui, Yoshinobu Sumiyama, Masakazu Yamamoto
Institutions: Kitakyushu City Hospital Organization, Kitakyushu City Yahata Hospital, Fujinomiya City General Hospital, Teikyo University, Washington University in St. Louis, Mayo Clinic, Mayo Clinic in Florida, Yokohama City University, Oita University, Keio University, Temple University, Yotsuya Medical Cube, Toho University Ohashi Medical Center, Seoul National University, Seoul National University Bundang Hospital, Taoyuan Chang Gung Memorial Hospital, Linkou Chang Gung Memorial Hospital, Kyushu University, Chang Bing Show Chwan Memorial Hospital, Ospedale Santa Maria di Loreto Nuovo, Agia Olga Hospital, Japanese Red Cross Nagoya Daini Hospital, Ogaki Municipal Hospital, Tokyo Medical University, Tokyo Medical University Hospital, Lilavati Hospital & Research Centre, University of Edinburgh, Fujita Health University, Ageo Central General Hospital, Hôpital Paul-Brousse, Universidad de Buenos Aires, Hospital Italiano de Buenos Aires, Universidad Hospital Italiano, Tokyo Women's Medical University, Tokyo Metropolitan Komagome Hospital, King Edward Memorial Hospital and Seth G.S. Medical College, Japan Council for Quality Health Care, International University of Health and Welfare Ichikawa Medical Center, International University of Health and Welfare, University of Occupational and Environmental Health Japan, Amsterdam UMC Location University of Amsterdam, Rush University Medical Center, National University of Singapore, Mount Elizabeth Novena Hospital, Cheng Hsin General Hospital, Hong Kong Sanatorium and Hospital, Yonsei University, Gangnam Severance Hospital, Konyang University Hospital, University of Cape Town, Groote Schuur Hospital, Tongji Hospital, Huazhong University of Science and Technology, Yuan's General Hospital, JR Sapporo Hospital, Toho University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Funders: University of Pittsburgh, Temple University, Teikyo University School of Medicine, Seoul National University Bundang Hospital, Keio University, Seoul National University, Chang Gung Medical Foundation, Washington University School of Medicine in St. Louis, College of Medicine, Seoul National University
OpenAlex ID: W2765764102