Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines.
Diagnostic criteria and severity assessment of acute cholecystitis: Tokyo Guidelines.
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DOI：
10.1007/s00534-006-1159-4
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Dervenis, Christos
中科院分区：
文献类型：
--
作者：
Hirota, Masahiko;Takada, Tadahiro;Kawarada, Yoshifumi;Nimura, Yuji;Miura, Fumihiko;Hirata, Koichi;Mayumi, Toshihiko;Yoshida, Masahiro;Strasberg, Steven;Pitt, Henry;Gadacz, Thomas R.;de Santibanes, Eduardo;Gouma, Dirk J.;Solomkin, Joseph S.;Belghiti, Jacques;Neuhaus, Horst;Buechler, Markus W.;Fan, Sheung-Tat;Ker, Chen-Guo;Padbury, Robert T.;Liau, Kui-Hin;Hilvano, Serafin C.;Belli, Giulio;Windsor, John A.;Dervenis, Christos
本文的目的是提出新的标准，急性胆囊炎的诊断和严重程度的评估，基于系统的文献回顾和专家的共识。一个工作组审查了关于急性胆囊炎的诊断和治疗的文章，并提取了目前最好的证据。除了证据和面对面的讨论外，专家们还举行了国内协商一致会议，以评估结果。2006年在东京举行的国际共识会议上讨论并最终确定了关于诊断标准和严重程度评估标准的临时结果声明。表现出炎症的局部体征之一，如墨菲氏征，或右上象限的肿块、疼痛或压痛，以及炎症的全身体征之一，如发热、升高的白色血细胞计数和升高的C-反应蛋白水平的患者被诊断为患有急性胆囊炎。通过诊断性成像证实疑似临床表现的患者也被诊断为急性胆囊炎。急性胆囊炎的严重程度分为三级，轻度（I级）、中度（II级）和重度（III级）。I级（轻度急性胆囊炎）定义为无器官功能障碍且胆囊病变有限的患者的急性胆囊炎，使胆囊切除术成为低风险手术。II级（中度急性胆囊炎）与无器官功能障碍相关，但胆囊中存在广泛疾病，导致难以安全地进行胆囊切除术。II级疾病的特征通常是白色血细胞计数升高;右上腹象限可触及的压痛肿块;疾病持续时间超过72小时;影像学研究表明胆囊有显著的炎症变化。III级（重度急性胆囊炎）定义为伴有器官功能障碍的急性胆囊炎。
The aim of this article is to propose new criteria for the diagnosis and severity assessment of acute cholecystitis, based on a systematic review of the literature and a consensus of experts. A working group reviewed articles with regard to the diagnosis and treatment of acute cholecystitis and extracted the best current available evidence. In addition to the evidence and face-to-face discussions, domestic consensus meetings were held by the experts in order to assess the results. A provisional outcome statement regarding the diagnostic criteria and criteria for severity assessment was discussed and finalized during an International Consensus Meeting held in Tokyo 2006. Patients exhibiting one of the local signs of inflammation, such as Murphy’s sign, or a mass, pain or tenderness in the right upper quadrant, as well as one of the systemic signs of inflammation, such as fever, elevated white blood cell count, and elevated C-reactive protein level, are diagnosed as having acute cholecystitis. Patients in whom suspected clinical findings are confirmed by diagnostic imaging are also diagnosed with acute cholecystitis. The severity of acute cholecystitis is classified into three grades, mild (grade I), moderate (grade II), and severe (grade III). Grade I (mild acute cholecystitis) is defined as acute cholecystitis in a patient with no organ dysfunction and limited disease in the gallbladder, making cholecystectomy a low-risk procedure. Grade II (moderate acute cholecystitis) is associated with no organ dysfunction but there is extensive disease in the gallbladder, resulting in difficulty in safely performing a cholecystectomy. Grade II disease is usually characterized by an elevated white blood cell count; a palpable, tender mass in the right upper abdominal quadrant; disease duration of more than 72 h; and imaging studies indicating significant inflammatory changes in the gallbladder. Grade III (severe acute cholecystitis) is defined as acute cholecystitis with organ dysfunction.
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DOI：
10.1007/bf02035103
发表时间：
1986-10-01
期刊：
GASTROINTESTINAL RADIOLOGY
影响因子：
--
作者：
MARTINEZ, A;BONA, X;MARTIN, J
通讯作者：
MARTIN, J
影响因子：
19.7
作者：
MAURO, MA;MCCARTNEY, WH;MELMED, JR
通讯作者：
MELMED, JR
影响因子：
1.3
作者：
Håkansson, K;Leander, P;Håkansson, HO
通讯作者：
Håkansson, HO
影响因子：
3.8
作者：
Merriam, LT;Kanaan, SA;Joehl, RJ
通讯作者：
Joehl, RJ
影响因子：
0.9
作者：
BREE, RL
通讯作者：
BREE, RL