Comparing outcomes of percutaneous cholecystostomy drain placement between patients within and outside of Tokyo guidelines diagnostic criteria for acute cholecystitis

2020 ◽  
Author(s):  
Alex Lionberg ◽  
Thomas Tullius ◽  
Teresa Jiang ◽  
Chukwuemeka Okafor ◽  
Travis Wassermann ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Diagnostic Criteria ◽  
Percutaneous Cholecystostomy ◽  
Tokyo Guidelines ◽  
Drain Placement

scholarly journals New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo guidelines

2012 ◽  
Vol 19 (5) ◽  
pp. 578-585 ◽  
Author(s):  
Masamichi Yokoe ◽  
Tadahiro Takada ◽  
Steven M. Strasberg ◽  
Joseph S. Solomkin ◽  
Toshihiko Mayumi ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Diagnostic Criteria ◽  
Severity Assessment ◽  
Tokyo Guidelines

scholarly journals COVID-19 outbreak and acute cholecystitis in a Hub Hospital in Milan: wider indications for percutaneous cholecystostomy

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matteo Barabino ◽  
Gaetano Piccolo ◽  
Arianna Trizzino ◽  
Veronica Fedele ◽  
Carlo Ferrari ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Percutaneous Cholecystostomy ◽  
Disease Evolution ◽  
Tokyo Guidelines ◽  
Gallbladder Drainage ◽  
National Health Care ◽  
Percutaneous Transhepatic Gallbladder Drainage ◽  
Italian National Health ◽  
Grade Ii ◽  
The Mean

Abstract Background COVID-19 pandemic has impacted the Italian National Health Care system at many different levels, causing a complete reorganization of surgical wards. In this context, our study retrospectively analysed the management strategy for patients with acute cholecystitis. Methods We analysed all patients admitted to our Emergency Department for acute cholecystitis between February and April 2020 and we graded each case according to 2018 Tokyo Guidelines. All patients were tested for positivity to SARS-CoV-2 and received an initial conservative treatment. We focused on patients submitted to cholecystostomy during the acute phase of pandemic and their subsequent disease evolution. Results Thirty-seven patients were admitted for acute cholecystitis (13 grade I, 16 grade II, 8 grade III). According to Tokyo Guidelines (2018), patients were successfully treated with antibiotic only, bedside percutaneous transhepatic gallbladder drainage (PC) and laparoscopic cholecystectomy (LC) in 29.7%, 21.6% and 48.7% of cases respectively. Therapeutic strategy of three out of 8 cases, otherwise fit for surgery, submitted to bedside percutaneous transhepatic gallbladder drainage (37.5%), were directly modified by COVID-19 pandemic: one due to the SARS-CoV-2 positivity, while two others due to unavailability of operating room and intensive care unit for post-operative monitoring respectively. Overall success rate of percutaneous cholecystostomy was of 87.5%. The mean post-procedural hospitalization length was 9 days, and no related adverse events were observed apart from transient parietal bleeding, conservatively treated. Once discharged, two patients required readmission because of acute biliary symptoms. Median time of drainage removal was 43 days and only 50% patients thereafter underwent cholecystectomy. Conclusions Percutaneous cholecystostomy has shown to be an effective and safe treatment thus acquiring an increased relevance in the first phase of the pandemic. Nowadays, considering we are forced to live with the SARS-CoV-2 virus, PC should be considered as a virtuous, alternative tool for potentially all COVID-19 positive patients and selectively for negative cases unresponsive to conservative therapy and unfit for surgery.

scholarly journals Acute Cholecystitis and the Controversies of Treatment

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Jessica Prince ◽  
Daniel Hancu
Keyword(s):  
Acute Cholecystitis ◽  
Symptom Control ◽  
Percutaneous Cholecystostomy ◽  
Tokyo Guidelines ◽  
Delayed Cholecystectomy ◽  
Control Hospital ◽  
Symptomatic Gallstones ◽  
Bail Out ◽  
Learning Points ◽  
Difficult Cases

Key Learning Points: 1. Acute cholecystitis is often a complication of gallstones disease 2. Most of patients with symptomatic gallstones disease are prone to further complications and cholecystectomy is indicated 3. Laparoscopic early cholecystectomy in acute cholecystitis is superior to delayed cholecystectomy in terms of symptom control, hospital stay and re-admissions, with similar morbidity and mortality and should be attempted in all cases of acute cholecystitis. Difficult cases should be managed by experienced surgeons, in advanced centers, and bail-out procedures should be attempted as per Tokyo guidelines. 4. Percutaneous cholecystostomy should only be used in patients unfit for surgery who fail to improve 5. The data available to support optimal antibiotical treatment is scarce, and local microbiology guidelines should be used.

An Acute General Surgical Unit (AGSU) Negates the Impact of the Tokyo Guidelines 2018 (TG18) Diagnostic Criteria for the Treatment of Acute Cholecystitis

2019 ◽  
Vol 43 (11) ◽  
pp. 2762-2769
Author(s):  
Yuchen Luo ◽  
Marang Makepe ◽  
Arthur Yim ◽  
Mark Tacey ◽  
David Bird ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Diagnostic Criteria ◽  
Tokyo Guidelines ◽  
The Impact ◽  
Surgical Unit

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

2018 ◽  
Vol 25 (1) ◽  
pp. 41-54 ◽  
Author(s):  
Masamichi Yokoe ◽  
Jiro Hata ◽  
Tadahiro Takada ◽  
Steven M. Strasberg ◽  
Horacio J. Asbun ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Diagnostic Criteria ◽  
Tokyo Guidelines ◽  
Severity Grading

scholarly journals Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines

2007 ◽  
Vol 14 (1) ◽  
pp. 78-82 ◽  
Author(s):  
Masahiko Hirota ◽  
Tadahiro Takada ◽  
Yoshifumi Kawarada ◽  
Yuji Nimura ◽  
Fumihiko Miura ◽  
...  
Keyword(s):  
Acute Cholecystitis ◽  
Diagnostic Criteria ◽  
Severity Assessment ◽  
Tokyo Guidelines

Validation of Tokyo Guidelines 2007 and Tokyo Guidelines 2013/2018 Criteria for Acute Cholangitis and Predictors of In-Hospital Mortality

2021 ◽  
pp. 1-9
Author(s):  
Ramkumar Mohan ◽  
Stefanie Wei Lynn Goh ◽  
Guan Wei Tan ◽  
Yen Pin Tan ◽  
Sameer P. Junnarkar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hospital Mortality ◽  
Diagnostic Criteria ◽  
Glasgow Coma Score ◽  
Acute Cholangitis ◽  
Tokyo Guidelines

<b><i>Background:</i></b> Acute cholangitis (AC) is a common emergency with a significant mortality risk. The Tokyo Guidelines (TG) provide recommendations for diagnosis, severity stratification, and management of AC. However, validation of the TG remains poor. This study aims to validate TG07, TG13, and TG18 criteria and identify predictors of in-hospital mortality in patients with AC. <b><i>Methods:</i></b> This is a retrospective audit of patients with a discharge diagnosis of AC in the year 2016. Demographic, clinical, investigation, management and mortality data were documented. We performed a multinomial logistic regression analysis with stepwise variable selection to identify severity predictors for in-hospital mortality. <b><i>Results:</i></b> Two hundred sixty-two patients with a median age of 75.9 years (IQR 64.8–82.8) years were included for analysis. TG13/TG18 diagnostic criteria were more sensitive than TG07 diagnostic criteria (85.1 vs. 75.2%; <i>p</i> &#x3c; 0.006). The majority of the patients (<i>n</i> = 178; 67.9%) presented with abdominal pain, pyrexia (<i>n</i> = 156; 59.5%), and vomiting (<i>n</i> = 123; 46.9%). Blood cultures were positive in 95 (36.3%) patients, and 79 (83.2%) patients had monomicrobial growth. The 30-day, 90-day, and in-hospital mortality numbers were 3 (1.1%), 11 (4.2%), and 15 (5.7%), respectively. In multivariate analysis, type 2 diabetes mellitus (OR = 12.531; 95% CI 0.354–116.015; <i>p</i> = 0.026), systolic blood pressure &#x3c;100 mm Hg (OR = 10.108; 95% CI 1.094–93.395; <i>p</i> = 0.041), Glasgow coma score &#x3c;15 (OR = 38.16; 95% CI 1.804–807.191; <i>p</i> = 0.019), and malignancy (OR = 14.135; 95% CI 1.017–196.394; <i>p</i> = 0.049) predicted in-hospital mortality. <b><i>Conclusion:</i></b> TG13/18 diagnostic criteria are more sensitive than TG07 diagnostic criteria. Type 2 diabetes mellitus, systolic blood pressure &#x3c;100 mm Hg, Glasgow coma score &#x3c;15, and malignant etiology predict in-hospital mortality in patients with AC. These predictors could be considered in acute stratification and treatment of patients with AC.

Sign in / Sign up

Export Citation Format

Share Document