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

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

Research output: Contribution to journalArticle

Abstract

Since its publication in 2007, the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) have been widely adopted. The validation of TG07 conducted in terms of clinical practice has shown that the diagnostic criteria for acute cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. Discussion by the Tokyo Guidelines Revision Committee concluded that acute cholecystitis should be suspected when Murphy's sign, local inflammatory findings in the gallbladder such as right upper quadrant abdominal pain and tenderness, and fever and systemic inflammatory reaction findings detected by blood tests are present but that definite diagnosis of acute cholecystitis can be made only on the basis of the imaging of ultrasonography, computed tomography or scintigraphy (HIDA scan). These proposed diagnostic criteria provided better specificity and accuracy rates than the TG07 diagnostic criteria. As for the severity assessment criteria in TG07, there is evidence that TG07 resulted in clarification of the concept of severe acute cholecystitis. Furthermore, there is evidence that severity assessment in TG07 has led to a reduction in the mean duration of hospital stay. As for the factors used to establish a moderate grade of acute cholecystitis, such as leukocytosis, ALP, old age, diabetes, being male, and delay in admission, no new strong evidence has been detected indicating that a change in the criteria used in TG07 is needed. Therefore, it was judged that the severity assessment criteria of TG07 could be applied in the updated Tokyo Guidelines (TG13) with minor changes. TG13 presents new standards for the diagnosis, severity grading and management of acute cholecystitis. Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/ guideline/tg13.html.

Original languageEnglish (US)
Pages (from-to)35-46
Number of pages12
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume20
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

Fingerprint

Acute Cholecystitis
Tokyo
Guidelines
Mobile Applications
Cholangitis
Leukocytosis
Hematologic Tests
Gallbladder
Radionuclide Imaging
Abdominal Pain
Publications
Ultrasonography
Length of Stay
Fever
Tomography

Keywords

  • Acute cholecystitis
  • Diagnostic criteria
  • Diagnostic imaging
  • Guidelines
  • Severity grading

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

Yokoe, M., Takada, T., Strasberg, S. M., Solomkin, J. S., Mayumi, T., Gomi, H., ... Ker, C. G. (2013). TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos). Journal of Hepato-Biliary-Pancreatic Sciences, 20(1), 35-46. https://doi.org/10.1007/s00534-012-0568-9

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, Angus C W; Lau, Wan Yee; Supe, Avinash N.; Belli, Giulio; Hilvano, Serafin C.; Liau, Kui Hin; Kim, Myung Hwan; Kim, Sun Whe; Ker, Chen Guo.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 20, No. 1, 01.2013, p. 35-46.

Research output: Contribution to journalArticle

Yokoe, M, Takada, T, Strasberg, SM, Solomkin, JS, Mayumi, T, Gomi, H, Pitt, HA, Garden, OJ, Kiriyama, S, Hata, J, Gabata, T, Yoshida, M, Miura, F, Okamoto, K, Tsuyuguchi, T, Itoi, T, Yamashita, Y, Dervenis, C, Chan, ACW, Lau, WY, Supe, AN, Belli, G, Hilvano, SC, Liau, KH, Kim, MH, Kim, SW & Ker, CG 2013, 'TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos)', Journal of Hepato-Biliary-Pancreatic Sciences, vol. 20, no. 1, pp. 35-46. https://doi.org/10.1007/s00534-012-0568-9
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, Angus C W ; Lau, Wan Yee ; Supe, Avinash N. ; Belli, Giulio ; Hilvano, Serafin C. ; Liau, Kui Hin ; Kim, Myung Hwan ; Kim, Sun Whe ; Ker, Chen Guo. / TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos). In: Journal of Hepato-Biliary-Pancreatic Sciences. 2013 ; Vol. 20, No. 1. pp. 35-46.
@article{ed33a7fb1400435a820292ebcf52eafb,
title = "TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos)",
abstract = "Since its publication in 2007, the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) have been widely adopted. The validation of TG07 conducted in terms of clinical practice has shown that the diagnostic criteria for acute cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. Discussion by the Tokyo Guidelines Revision Committee concluded that acute cholecystitis should be suspected when Murphy's sign, local inflammatory findings in the gallbladder such as right upper quadrant abdominal pain and tenderness, and fever and systemic inflammatory reaction findings detected by blood tests are present but that definite diagnosis of acute cholecystitis can be made only on the basis of the imaging of ultrasonography, computed tomography or scintigraphy (HIDA scan). These proposed diagnostic criteria provided better specificity and accuracy rates than the TG07 diagnostic criteria. As for the severity assessment criteria in TG07, there is evidence that TG07 resulted in clarification of the concept of severe acute cholecystitis. Furthermore, there is evidence that severity assessment in TG07 has led to a reduction in the mean duration of hospital stay. As for the factors used to establish a moderate grade of acute cholecystitis, such as leukocytosis, ALP, old age, diabetes, being male, and delay in admission, no new strong evidence has been detected indicating that a change in the criteria used in TG07 is needed. Therefore, it was judged that the severity assessment criteria of TG07 could be applied in the updated Tokyo Guidelines (TG13) with minor changes. TG13 presents new standards for the diagnosis, severity grading and management of acute cholecystitis. Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/ guideline/tg13.html.",
keywords = "Acute cholecystitis, Diagnostic criteria, Diagnostic imaging, Guidelines, Severity grading",
author = "Masamichi Yokoe and Tadahiro Takada and Strasberg, {Steven M.} and Solomkin, {Joseph S.} and Toshihiko Mayumi and Harumi Gomi and Pitt, {Henry A.} and Garden, {O. James} and Seiki Kiriyama and Jiro Hata and Toshifumi Gabata and Masahiro Yoshida and Fumihiko Miura and Kohji Okamoto and Toshio Tsuyuguchi and Takao Itoi and Yuichi Yamashita and Christos Dervenis and Chan, {Angus C W} and Lau, {Wan Yee} and Supe, {Avinash N.} and Giulio Belli and Hilvano, {Serafin C.} and Liau, {Kui Hin} and Kim, {Myung Hwan} and Kim, {Sun Whe} and Ker, {Chen Guo}",
year = "2013",
month = "1",
doi = "10.1007/s00534-012-0568-9",
language = "English (US)",
volume = "20",
pages = "35--46",
journal = "Journal of Hepato-Biliary-Pancreatic Sciences",
issn = "1868-6974",
publisher = "Springer Verlag",
number = "1",

}

TY - JOUR

T1 - TG13 diagnostic criteria and severity grading of acute cholecystitis (with videos)

AU - Yokoe, Masamichi

AU - Takada, Tadahiro

AU - Strasberg, Steven M.

AU - Solomkin, Joseph S.

AU - Mayumi, Toshihiko

AU - Gomi, Harumi

AU - Pitt, Henry A.

AU - Garden, O. James

AU - Kiriyama, Seiki

AU - Hata, Jiro

AU - Gabata, Toshifumi

AU - Yoshida, Masahiro

AU - Miura, Fumihiko

AU - Okamoto, Kohji

AU - Tsuyuguchi, Toshio

AU - Itoi, Takao

AU - Yamashita, Yuichi

AU - Dervenis, Christos

AU - Chan, Angus C W

AU - Lau, Wan Yee

AU - Supe, Avinash N.

AU - Belli, Giulio

AU - Hilvano, Serafin C.

AU - Liau, Kui Hin

AU - Kim, Myung Hwan

AU - Kim, Sun Whe

AU - Ker, Chen Guo

PY - 2013/1

Y1 - 2013/1

N2 - Since its publication in 2007, the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) have been widely adopted. The validation of TG07 conducted in terms of clinical practice has shown that the diagnostic criteria for acute cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. Discussion by the Tokyo Guidelines Revision Committee concluded that acute cholecystitis should be suspected when Murphy's sign, local inflammatory findings in the gallbladder such as right upper quadrant abdominal pain and tenderness, and fever and systemic inflammatory reaction findings detected by blood tests are present but that definite diagnosis of acute cholecystitis can be made only on the basis of the imaging of ultrasonography, computed tomography or scintigraphy (HIDA scan). These proposed diagnostic criteria provided better specificity and accuracy rates than the TG07 diagnostic criteria. As for the severity assessment criteria in TG07, there is evidence that TG07 resulted in clarification of the concept of severe acute cholecystitis. Furthermore, there is evidence that severity assessment in TG07 has led to a reduction in the mean duration of hospital stay. As for the factors used to establish a moderate grade of acute cholecystitis, such as leukocytosis, ALP, old age, diabetes, being male, and delay in admission, no new strong evidence has been detected indicating that a change in the criteria used in TG07 is needed. Therefore, it was judged that the severity assessment criteria of TG07 could be applied in the updated Tokyo Guidelines (TG13) with minor changes. TG13 presents new standards for the diagnosis, severity grading and management of acute cholecystitis. Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/ guideline/tg13.html.

AB - Since its publication in 2007, the Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) have been widely adopted. The validation of TG07 conducted in terms of clinical practice has shown that the diagnostic criteria for acute cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. Discussion by the Tokyo Guidelines Revision Committee concluded that acute cholecystitis should be suspected when Murphy's sign, local inflammatory findings in the gallbladder such as right upper quadrant abdominal pain and tenderness, and fever and systemic inflammatory reaction findings detected by blood tests are present but that definite diagnosis of acute cholecystitis can be made only on the basis of the imaging of ultrasonography, computed tomography or scintigraphy (HIDA scan). These proposed diagnostic criteria provided better specificity and accuracy rates than the TG07 diagnostic criteria. As for the severity assessment criteria in TG07, there is evidence that TG07 resulted in clarification of the concept of severe acute cholecystitis. Furthermore, there is evidence that severity assessment in TG07 has led to a reduction in the mean duration of hospital stay. As for the factors used to establish a moderate grade of acute cholecystitis, such as leukocytosis, ALP, old age, diabetes, being male, and delay in admission, no new strong evidence has been detected indicating that a change in the criteria used in TG07 is needed. Therefore, it was judged that the severity assessment criteria of TG07 could be applied in the updated Tokyo Guidelines (TG13) with minor changes. TG13 presents new standards for the diagnosis, severity grading and management of acute cholecystitis. Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/ guideline/tg13.html.

KW - Acute cholecystitis

KW - Diagnostic criteria

KW - Diagnostic imaging

KW - Guidelines

KW - Severity grading

UR - http://www.scopus.com/inward/record.url?scp=84873467396&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84873467396&partnerID=8YFLogxK

U2 - 10.1007/s00534-012-0568-9

DO - 10.1007/s00534-012-0568-9

M3 - Article

C2 - 23340953

AN - SCOPUS:84873467396

VL - 20

SP - 35

EP - 46

JO - Journal of Hepato-Biliary-Pancreatic Sciences

JF - Journal of Hepato-Biliary-Pancreatic Sciences

SN - 1868-6974

IS - 1

ER -