Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos)

Masamichi Yokoe, Jiro Hata, Tadahiro Takada, Steven M. Strasberg, Horacio J. Asbun, Go Wakabayashi, Kazuto Kozaka, Itaru Endo, Daniel J. Deziel, Fumihiko Miura, Kohji Okamoto, Tsann Long Hwang, Wayne Shih Wei Huang, Chen Guo Ker, Miin Fu Chen, Ho Seong Han, Yoo Seok Yoon, In Seok Choi, Dong Sup Yoon, Yoshinori NoguchiSatoru Shikata, Tomohiko Ukai, Ryota Higuchi, Toshifumi Gabata, Yasuhisa Mori, Yukio Iwashita, Taizo Hibi, Palepu Jagannath, Eduard Jonas, Kui Hin Liau, Christos Dervenis, Dirk J. Gouma, Daniel Cherqui, Giulio Belli, O. James Garden, Mariano Eduardo Giménez, Eduardo de Santibañes, Kenji Suzuki, Akiko Umezawa, Avinash Nivritti Supe, Henry A. Pitt, Harjit Singh, Angus C.W. Chan, Wan Yee Lau, Anthony Yuen Bun Teoh, Goro Honda, Atsushi Sugioka, Koji Asai, Harumi Gomi, Takao Itoi, Seiki Kiriyama, Masahiro Yoshida, Toshihiko Mayumi, Naoki Matsumura, Hiromi Tokumura, Seigo Kitano, Koichi Hirata, Kazuo Inui, Yoshinobu Sumiyama, Masakazu Yamamoto

Research output: Contribution to journalArticlepeer-review

669 Citations (Scopus)

Abstract

The Tokyo Guidelines 2013 (TG13) for acute cholangitis and cholecystitis were globally disseminated and various clinical studies about the management of acute cholecystitis were reported by many researchers and clinicians from all over the world. The 1st edition of the Tokyo Guidelines 2007 (TG07) was revised in 2013. According to that revision, the TG13 diagnostic criteria of acute cholecystitis provided better specificity and higher diagnostic accuracy. Thorough our literature search about diagnostic criteria for acute cholecystitis, new and strong evidence that had been released from 2013 to 2017 was not found with serious and important issues about using TG13 diagnostic criteria of acute cholecystitis. On the other hand, the TG13 severity grading for acute cholecystitis has been validated in numerous studies. As a result of these reviews, the TG13 severity grading for acute cholecystitis was significantly associated with parameters including 30-day overall mortality, length of hospital stay, conversion rates to open surgery, and medical costs. In terms of severity assessment, breakthrough and intensive literature for revising severity grading was not reported. Consequently, TG13 diagnostic criteria and severity grading were judged from numerous validation studies as useful indicators in clinical practice and adopted as TG18/TG13 diagnostic criteria and severity grading of acute cholecystitis without any modification. 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.

Original languageEnglish
Pages (from-to)41-54
Number of pages14
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume25
Issue number1
DOIs
Publication statusPublished - 01-2018

All Science Journal Classification (ASJC) codes

  • Surgery
  • Hepatology

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