TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos)

Yokoe, Masamichi; Takada, Tadahiro; Strasberg, Steven M.; Solomkin, Joseph S.; Mayumi, Toshihiko; Gomi, Harumi; Pitt, Henry A.; Garden, O. James; Kiriyama, Seiki; Hata, Jiro; Gabata, Toshifumi; Yoshida, Masahiro; Miura, Fumihiko; Okamoto, Kohji; Tsuyuguchi, Toshio; Itoi, Takao; Yamashita, Yuichi; Dervenis, Christos; Chan, Annie On On; Lau, Wan Yee; Supe, Avinash; Belli, Giulio; Hilvano, Serafin C.; Liau, Kui Hin; Kim, Myung Hwan; Kim, Sun Whe; Ker, Chen Guo

doi:10.1007/s00534-012-0568-9

Cited by 370 publications

(348 citation statements)

References 60 publications

Supporting

Mentioning

327

Contrasting

Unclassified

Order By: Relevance

“…For TG13, the diagnostic accuracy of US for AC has been reported to have 50% to 88% sensitivity and 80% to 88% specificity [18]. The fact that sonographic Murphy's sign is the finding with the highest specificity and is useful for diagnosis is also mentioned in TG13; however, in our study it was positive in only 13.2% of cases.…”

Section: Discussioncontrasting

confidence: 51%

See 1 more Smart Citation

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Yokoe

Takada

Hwang

et al. 2017

J Hepato Biliary Pancreat

Self Cite

View full text Add to dashboard Cite

Background Since the publication of the Tokyo Guidelines (TG13) for the management of acute cholecystitis (AC), multidirectional studies have been published. However, epidemiological research about AC with big data was not projected. The aim of this study was to reveal the actual clinical conditions of AC. Method The study was designed as an international multicenter retrospective study of AC in Japan and Taiwan from 2011 to 2013. The factors investigated comprised data related to demographic, history, physical examinations, laboratory and imaging findings. Based on these data, we investigated the various values of AC, and real situation with respect to severity and treatment. Results A total of 5,459 patients with AC were reviewed. Thirty-day mortality rate was 1.1%. Based on the diagnostic criteria, 4,088 patients had a definite diagnosis and 291 had a suspected diagnosis. According to the severity grading, 939 patients were classified as Grade III, 2,308 as Grade II, and 2,130 as Grade I. Cholecystectomy was performed in total of 4,266 patients and 2,765 patients had laparoscopic cholecystectomy. The main etiologies were gallbladder stones in 4,623 cases. Conclusion This epidemiological study with large population will undoubtedly contribute to establish the best practice for managing AC worldwide.

show abstract

Section: Discussioncontrasting

confidence: 51%

“…As a matter of course, taking the results of previous various evaluations about TG07 guidelines [12][13][14][15][16] into the revising process, revised guidelines were published in 2013 as TG13 [17][18][19][20].…”

mentioning

confidence: 99%

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Yokoe

Takada

Hwang

et al. 2017

J Hepato Biliary Pancreat

Self Cite

View full text Add to dashboard Cite

show abstract

“…According to the Tokyo Guidelines 2013 (TG13) (18), the patients' conditions were diagnosed as acute cholecystitis based on the following criteria: clinical symptoms showing right upper quadrant or epigastric pain or tenderness, signs of systemic inflammation (fever, elevated white blood cell count, and C-reactive protein), or positive findings on abdominal ultrasonography (US) or computed tomography (CT).…”

Section: Methodsmentioning

confidence: 99%

Efficacy and Safety of Endoscopic Gallbladder Stenting for Acute Cholecystitis in Patients with Concomitant Unresectable Cancer

et al. 2016

Self Cite

View full text Add to dashboard Cite

Objective Endoscopic gallbladder stenting (EGBS) is an alternative treatment option for high-risk surgical patients with acute cholecystitis. However, there are no reports focusing on EGBS in patients with concomitant unresectable cancer. The aim of this study was thus to evaluate EGBS in such patients. Methods Twenty-two consecutive patients with acute cholecystitis and unresectable cancer were enrolled between September 2010 and December 2014. Their median age was 74.5 years (range: 51-95). Thirteen patients were men and nine were women. The primary cancers of the patients were biliary tract cancer (9), pancreas cancer (9), lung cancer (2), gastric cancer (1), and colon cancer (1). The causes of cholecystitis were calculus cholecystitis (7), obstruction by malignant tumor (13), and obstruction by fully covered stent (2). Results EGBS was successfully performed in 17 patients (77.2%). The technical success rates for calculus cholecystitis, obstruction by malignant tumor, and obstruction by fully covered stent were 85.7% (6/7), 69.2% (9/13), and 100% (2/2), respectively. No complications were observed. Percutaneous transhepatic gallbladder drainage was conducted on two patients in whom EGBS had failed and then we performed EGBS by a rendezvous approach. Of the 19 patients in whom we finally deployed EGBS, the median follow-up period was 229 days (range: 14-880 days). A recurrence of acute cholecystitis occurred in three (15.7%) patients 14, 130, and 440 days after EGBS placement. The rates of recurrence of cholecystitis at one and two years were 10.5% and 18.7%, respectively. Conclusion Our study demonstrated that EGBS is a safe and effective method for acute cholecystitis in patients with concomitant unresectable cancer.

show abstract

“…However, we do systematically utilize the ASA classification prior to a planned delayed surgery. In the Tokyo clinical guidelines, organic dysfunction scales are employed (Marshall, SOFA) to evaluate grade III acute cholecystitis [34]. In the therapeutic algorithms of these same guidelines, biliary drainage is recommended for patients with grade II and III acute cholecystitis and high surgical risk [35][36].…”

Section: Discussionmentioning

confidence: 99%

Improving the outcome of acute cholecystitis: the non-standardized treatment must no longer be employed

González-Muñoz

Angoso

Sayagués

et al. 2014

Langenbecks Arch Surg

View full text Add to dashboard Cite

Disclosure:The authors declare no conflict of interest. Number of text pages: 17Tables: 1 Figures: 2 Word count: 2222 AbstractPurpose Therapeutic recommendations of acute cholecystitis are not consistently implemented, which generates greater patient morbidity and higher health care costs.The aim of this article is to evaluate the burden of acute cholecystitis, to detect potentially modifiable variables and to propose a therapeutic strategy that will allow us to improve the quality of care.Methods We carried out a retrospective study of patients who were admitted to the hospital from January 2010 to December 2012 using a univariate analysis of parameters including the admitting department, age, treatment administered and length of stay.Results A total of 967 patients were admitted to the hospital with a diagnosis of acute cholecystitis, 692 (72%) to the Surgery department, 257 (26%) to Internal MedicineDigestive and 18 (2%) to other departments. 498 (51.5%) were operated on: 107 (21%) on an urgent basis, 111 (22%) at an early stage (<96 hours at diagnosis), 152 (30%) at a late stage (>96 hours at diagnosis) and 128 (26%) at a delayed date (other admission).Patients who were admitted into the surgery department were five times more likely to be operated on than patients admitted into other departments (p<0.01). Patients operated on at a late stage had a longer length of stay than early stage surgery patients (p<0.05) and than non operated ones (p<0.05). Patients <74 years old were more frequently operated than older ones (p<0.05). ConclusionsThe non-standardized treatment of acute cholecystitis causes high clinical and surgical variability, long average stay, more re-admissions and high hospital costs.Therefore, patients with a diagnosis of acute cholecystitis should be admitted to the Surgery department, thereby increasing the probability of receiving definite treatment.

show abstract

TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos)

Cited by 370 publications

References 60 publications

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Descriptive review of acute cholecystitis: Japan‐Taiwan collaborative epidemiological study

Efficacy and Safety of Endoscopic Gallbladder Stenting for Acute Cholecystitis in Patients with Concomitant Unresectable Cancer

Improving the outcome of acute cholecystitis: the non-standardized treatment must no longer be employed

Contact Info

Product

Resources

About