TG13 surgical management of acute cholecystitis

Yuichi Yamashita, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Dirk J. Gouma, O. James Garden, Markus W. Büchler, Harumi Gomi, Christos Dervenis, John A. Windsor, Sun Whe Kim, Eduardo De Santibanes, Robert Padbury, Xiao Ping Chen, Angus C W Chan, Sheung Tat Fan, Palepu Jagannath, Toshihiko Mayumi, Masahiro Yoshida, Fumihiko Miura & 3 others Toshio Tsuyuguchi, Takao Itoi, Avinash N. Supe

Research output: Contribution to journalArticle

Abstract

Background: Laparoscopic cholecystectomy is now accepted as a surgical procedure for acute cholecystitis when it is performed by an expert surgeon. There are several lines of strong evidence, such as randomized controlled trials (RCTs) and meta-analyses, supporting the introduction of laparoscopic cholecystectomy for patients with acute cholecystitis. The updated Tokyo Guidelines 2013 (TG13) describe the surgical treatment for acute cholecystitis according to the grade of severity, the timing, and the procedure used for cholecystitis in a question-and-answer format using the evidence concerning surgical management of acute cholecystitis. Methods and materials: Forty-eight publications were selected for a careful examination of their full texts, and the types of surgical management of acute cholecystitis were investigated using this evidence. The items concerning the surgical management of acute cholecystitis were the optimal surgical treatment for acute cholecystitis according to the grade of severity, optimal timing for the cholecystectomy, surgical procedure used for cholecystectomy, optimal timing of the conversion of cholecystectomy from laparoscopic to open surgery, and the complications of laparoscopic cholecystectomy. Results: There were eight RCTs and four meta-analyses concerning the optimal timing of the cholecystectomy. Consequently, it was found that cholecystectomy is preferable early after admission. There were three RCTs and two meta-analyses concerning the surgical procedure, which concluded that laparoscopic cholecystectomy is preferable to open procedures. Literature concerning the surgical treatment according to the grade of severity could not be quoted, because there have been no publications on this topic. Therefore, the treatment was determined based on the general opinions of professionals. Conclusion: Surgical management of acute cholecystitis in the updated TG13 is fundamentally the same as in the Tokyo Guidelines 2007 (TG07), and the concept of a critical view of safety and the existence of extreme vasculobiliary injury are added in the text to call the surgeon's attention to the need to reduce the incidence of bile duct injury. 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)89-96
Number of pages8
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume20
Issue number1
DOIs
StatePublished - Jan 2013
Externally publishedYes

Fingerprint

Acute Cholecystitis
Tokyo
Laparoscopic Cholecystectomy
Guidelines
Cholecystectomy
Meta-Analysis
Randomized Controlled Trials
Publications
Mobile Applications
Cholecystitis
Wounds and Injuries
Therapeutics
Bile Ducts
Safety
Incidence

Keywords

  • Acute cholecystitis
  • Bile duct injury
  • Cholecystostomy
  • Gallbladder drainage
  • Laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Hepatology
  • Surgery

Cite this

Yamashita, Y., Takada, T., Strasberg, S. M., Pitt, H. A., Gouma, D. J., Garden, O. J., ... Supe, A. N. (2013). TG13 surgical management of acute cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences, 20(1), 89-96. https://doi.org/10.1007/s00534-012-0567-x

TG13 surgical management of acute cholecystitis. / Yamashita, Yuichi; Takada, Tadahiro; Strasberg, Steven M.; Pitt, Henry A.; Gouma, Dirk J.; Garden, O. James; Büchler, Markus W.; Gomi, Harumi; Dervenis, Christos; Windsor, John A.; Kim, Sun Whe; De Santibanes, Eduardo; Padbury, Robert; Chen, Xiao Ping; Chan, Angus C W; Fan, Sheung Tat; Jagannath, Palepu; Mayumi, Toshihiko; Yoshida, Masahiro; Miura, Fumihiko; Tsuyuguchi, Toshio; Itoi, Takao; Supe, Avinash N.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 20, No. 1, 01.2013, p. 89-96.

Research output: Contribution to journalArticle

Yamashita, Y, Takada, T, Strasberg, SM, Pitt, HA, Gouma, DJ, Garden, OJ, Büchler, MW, Gomi, H, Dervenis, C, Windsor, JA, Kim, SW, De Santibanes, E, Padbury, R, Chen, XP, Chan, ACW, Fan, ST, Jagannath, P, Mayumi, T, Yoshida, M, Miura, F, Tsuyuguchi, T, Itoi, T & Supe, AN 2013, 'TG13 surgical management of acute cholecystitis', Journal of Hepato-Biliary-Pancreatic Sciences, vol. 20, no. 1, pp. 89-96. https://doi.org/10.1007/s00534-012-0567-x
Yamashita Y, Takada T, Strasberg SM, Pitt HA, Gouma DJ, Garden OJ et al. TG13 surgical management of acute cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences. 2013 Jan;20(1):89-96. https://doi.org/10.1007/s00534-012-0567-x
Yamashita, Yuichi ; Takada, Tadahiro ; Strasberg, Steven M. ; Pitt, Henry A. ; Gouma, Dirk J. ; Garden, O. James ; Büchler, Markus W. ; Gomi, Harumi ; Dervenis, Christos ; Windsor, John A. ; Kim, Sun Whe ; De Santibanes, Eduardo ; Padbury, Robert ; Chen, Xiao Ping ; Chan, Angus C W ; Fan, Sheung Tat ; Jagannath, Palepu ; Mayumi, Toshihiko ; Yoshida, Masahiro ; Miura, Fumihiko ; Tsuyuguchi, Toshio ; Itoi, Takao ; Supe, Avinash N. / TG13 surgical management of acute cholecystitis. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2013 ; Vol. 20, No. 1. pp. 89-96.
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AU - Yamashita, Yuichi

AU - Takada, Tadahiro

AU - Strasberg, Steven M.

AU - Pitt, Henry A.

AU - Gouma, Dirk J.

AU - Garden, O. James

AU - Büchler, Markus W.

AU - Gomi, Harumi

AU - Dervenis, Christos

AU - Windsor, John A.

AU - Kim, Sun Whe

AU - De Santibanes, Eduardo

AU - Padbury, Robert

AU - Chen, Xiao Ping

AU - Chan, Angus C W

AU - Fan, Sheung Tat

AU - Jagannath, Palepu

AU - Mayumi, Toshihiko

AU - Yoshida, Masahiro

AU - Miura, Fumihiko

AU - Tsuyuguchi, Toshio

AU - Itoi, Takao

AU - Supe, Avinash N.

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N2 - Background: Laparoscopic cholecystectomy is now accepted as a surgical procedure for acute cholecystitis when it is performed by an expert surgeon. There are several lines of strong evidence, such as randomized controlled trials (RCTs) and meta-analyses, supporting the introduction of laparoscopic cholecystectomy for patients with acute cholecystitis. The updated Tokyo Guidelines 2013 (TG13) describe the surgical treatment for acute cholecystitis according to the grade of severity, the timing, and the procedure used for cholecystitis in a question-and-answer format using the evidence concerning surgical management of acute cholecystitis. Methods and materials: Forty-eight publications were selected for a careful examination of their full texts, and the types of surgical management of acute cholecystitis were investigated using this evidence. The items concerning the surgical management of acute cholecystitis were the optimal surgical treatment for acute cholecystitis according to the grade of severity, optimal timing for the cholecystectomy, surgical procedure used for cholecystectomy, optimal timing of the conversion of cholecystectomy from laparoscopic to open surgery, and the complications of laparoscopic cholecystectomy. Results: There were eight RCTs and four meta-analyses concerning the optimal timing of the cholecystectomy. Consequently, it was found that cholecystectomy is preferable early after admission. There were three RCTs and two meta-analyses concerning the surgical procedure, which concluded that laparoscopic cholecystectomy is preferable to open procedures. Literature concerning the surgical treatment according to the grade of severity could not be quoted, because there have been no publications on this topic. Therefore, the treatment was determined based on the general opinions of professionals. Conclusion: Surgical management of acute cholecystitis in the updated TG13 is fundamentally the same as in the Tokyo Guidelines 2007 (TG07), and the concept of a critical view of safety and the existence of extreme vasculobiliary injury are added in the text to call the surgeon's attention to the need to reduce the incidence of bile duct injury. Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html.

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KW - Bile duct injury

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KW - Gallbladder drainage

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