2016 WSES guidelines on acute calculous cholecystitis

Ansaloni, Luca; Pisano, Michele; Coccolini, Federico; Peitzmann, Andrew; Fingerhut, Abe; Catena, Fausto; Agresta, Ferdinando; Allegri, A; Bailey, Ian; Balogh, Zsolt J.; Bendinelli, Cino; Biffl, Walter L.; Bonavina, Luigi; Borzellino, Giuseppe; Brunetti, Francesco; Burlew, Clay Cothren; Camapanelli, G.; Campanile, Fabio Cesare; Ceresoli, Marco; Chiara, Osvaldo; Civil, Ian; Coimbra, Raúl; Moya, Mark De; Saverio, Salomone Di; Fraga, Gustavo Pereira; Gupta, Sanjay; Kashuk, Jeffry L.; Kelly, Michael D.; Koka, Venkata; Jeekel, Hans; Latifi, Rifat; Leppäniemi, Ari; Maier, Ronald V.; Marzi, Ingo; Moore, Frederick A.; Piazzalunga, Dario; Sakakushev, Boris; Sartelli, Massimo; Scalea, Thomas M.; Stahel, Philip F.; Taviloğlu, Korhan; Tugnoli, Gregorio; Uraneus, S.; Velmahos, George C.; Wani, Iftikhar H; Weber, Dieter; Viale, Pierluigi; Sugrue, Michael; Ivatury, Rao R.; Kluger, Yoram; Gurusamy, Kurinchi Selvan; Moore, Ernest E.

doi:10.17116/endoskop201723625-71

Cited by 54 publications

(92 citation statements)

References 146 publications

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“…To date, no diagnostic criteria for acute cholecystitis meriting that title have been established other than TG13 . However, studies of the diagnostic yield of the TG13 diagnostic criteria are limited .…”

Section: Introductionmentioning

confidence: 99%

“…The use of neutrophil count alone for the definitive diagnosis of acute cholecystitis is unrealistic. The World Society of Emergency Surgery guidelines for acute calculous cholecystitis, which are restricted to cholecystitis due to calculi, recommend the combined use of clinical, laboratory, and imaging findings for diagnosis, without designating new diagnostic criteria . The TG13 diagnostic criteria for acute cholecystitis constitute exactly this combination, and we considered that they share the same concept for the designation of diagnostic criteria.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Yokoe

Hata

Takada

et al. 2018

J Hepato Biliary Pancreat

814

503

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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 1 st 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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Yokoe

Hata

Takada

et al. 2018

J Hepato Biliary Pancreat

814

503

View full text Add to dashboard Cite

show abstract

“…Current national guidance from the UK National Institute for Health and Care Excellence (NICE) is for laparoscopic cholecystectomy to be done within 7 days of a diagnosis of acute cholecystitis, and within the index admission for pancreatitis. Guidelines from the International Hepato‐Pancreato Biliary Association, World Society of Emergency Surgery and British Society of Gastroenterologists provide similar guidance on times to cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy

et al. 2019

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BackgroundAcute gallstone disease is a high‐volume emergency general surgery presentation with wide variations in the quality of care provided across the UK. This controlled cohort evaluation assessed whether participation in a quality improvement collaborative approach reduced time to surgery for patients with acute gallstone disease to fewer than 8 days from presentation, in line with national guidance.MethodsPatients admitted to hospital with acute biliary conditions in England and Wales between 1 April 2014 and 31 December 2017 were identified from Hospital Episode Statistics data. Time series of quarterly activity were produced for the Cholecystectomy Quality Improvement Collaborative (Chole‐QuIC) and all other acute National Health Service hospitals (control group). A negative binomial regression model was used to compare the proportion of patients having surgery within 8 days in the baseline and intervention periods.ResultsOf 13 sites invited to join Chole‐QuIC, 12 participated throughout the collaborative, which ran from October 2016 to January 2018. Of 7944 admissions, 1160 patients had a cholecystectomy within 8 days of admission, a significant improvement (P < 0·050) from baseline performance. This represented a relative change of 1·56 (95 per cent c.i. 1·38 to 1·75), compared with 1·08 for the control group. At the individual site level, eight of the 12 Chole‐QuIC sites showed a significant improvement (P < 0·050), with four sites increasing their 8‐day surgery rate to over 20 per cent of all emergency admissions, well above the mean of 15·3 per cent for control hospitals.ConclusionA surgeon‐led quality improvement collaborative approach improved care for patients requiring emergency cholecystectomy.

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“…However, there remains ambiguity and variability in the symptom duration that qualifies for ELC. Different authors have defined variable time criteria, ranging from cholecystectomy being performed within 24 h of admission to within 10 days of symptom onset . The updated 2018 Tokyo Guidelines suggest that ELC should preferably be performed within 72 h of symptom onset but has acknowledged that this may not be always possible in practice.…”

Section: Introductionmentioning

confidence: 99%

Early laparoscopic cholecystectomy by a dedicated emergency surgical unit confers excellent outcomes in acute cholecystitis presenting beyond 72 hours

Chia

Goh

et al. 2019

ANZ Journal of Surgery

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Background Early laparoscopic cholecystectomy (ELC) within 72 h of symptom onset is preferred for management of acute cholecystitis (AC). Beyond 72 h, acute‐on‐chronic fibrosis sets in rendering surgery challenging. This study aims to compare the outcomes of ELC for AC within and beyond 72 h of symptom onset by a dedicated acute surgical unit. Methods This is a single‐centre retrospective study of 217 patients with AC who underwent ELC by an acute surgical unit from January 2017 to August 2018. Outcomes collected include post‐operative morbidity, length of hospitalization and operation duration. A subgroup analysis for the same outcomes was performed for elderly patients. Results Of the 217 patients, 88 were operated within 72 h of symptom onset while 129 were operated beyond 72 h. Twenty‐six patients received ELC after 7 days. There was no occurrence of bile duct injury. There was no statistical difference in conversion rates, wound infections and post‐operative collections. Patients receiving ELC beyond 72 h had longer duration of operation (125.4 versus 116 min, P = 0.035) and length of hospitalization (4.59 versus 3.09 days, P = 0.001) without increase in morbidity. Patients older than 75 years had a higher incidence of post‐operative collection (P < 0.001). Conclusion Patients with AC undergoing ELC by a dedicated acute surgical unit can have good outcomes even beyond 72 h of symptom onset. Meticulous haemostasis should be performed for the elderly subgroup of patients.

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2016 WSES guidelines on acute calculous cholecystitis

Cited by 54 publications

References 146 publications

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

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

Effectiveness of a quality improvement collaborative in reducing time to surgery for patients requiring emergency cholecystectomy

Early laparoscopic cholecystectomy by a dedicated emergency surgical unit confers excellent outcomes in acute cholecystitis presenting beyond 72 hours

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