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)
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DOI：
10.1002/jhbp.515
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发表时间：
2018-01-01
影响因子：
3
通讯作者：
Yamamoto, Masakazu
中科院分区：
文献类型：
--
作者：
Yokoe, Masamichi;Hata, Jiro;Yamamoto, Masakazu
急性胆管炎和胆囊炎东京指南2013（TG 13）在全球范围内传播，世界各地的许多研究人员和临床医生报告了关于急性胆囊炎管理的各种临床研究。2007年东京指南（TG 07）第一版于2013年修订。TG 13诊断急性胆囊炎的特异性和准确性更高。通过我们对急性胆囊炎诊断标准的文献检索，未发现2013年至2017年发布的关于使用TG 13诊断标准的严重和重要问题的新的有力证据。另一方面，急性胆囊炎的TG 13严重程度分级已在许多研究中得到验证。作为这些综述的结果，急性胆囊炎的TG 13严重程度分级与包括30天总死亡率、住院时间、开放手术转换率和医疗费用在内的参数显著相关。在严重度评估方面，未报告修订严重度分级的突破性和密集性文献。因此，TG 13诊断标准和严重程度分级从大量验证研究中被判定为临床实践中有用的指标，并被采用为TG 18/TG 13诊断标准和急性胆囊炎严重程度分级，未作任何修改。TG 18的免费完整文章和移动的应用程序可在http://www.jshbps.jp/modules/en/index.php?上获得content_id=47.相关的临床问题和参考文献也包括在内。
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 1st 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.