Abstract
The aim of the present study was to evaluate the problem of the severity assessment criteria for acute cholangitis and cholecystitis. Three hundred and thirteen patients with acute cholangitis and cholecystitis underwent surgical treatment. They were classified into two groups [(A) older and (B) younger than 70 years] by the current JPN guidelines for the management of acute cholangitis and cholecystitis. Of the 131 patients with acute cholangitis, there were no significant differences in the total interval and hospital days between group A and B. Among these acute cholangitis patients, (group A/B) 22%/14.3% were classified as mild, 64.6%/69.4% as moderate and 13.4%/16.3% as severe. Moderate patients with 2 positive factors demonstrated higher levels of emergency treatment than patients with one positive factor. In 182 acute cholecystitis patients, the total interval and hospital days in group A were significantly longer than in group B. Among these acute cholecystitis patients (group A/B), 36.7%/38.8% were classified as mild, 25.3%/19.4% as moderate and 63.3%/41.7% as severe. Severe patients with 2 positive factors in group A underwent more emergency treatment than the patients with 1 positive factor. Our results strongly suggest that the difference in the importance of factors and a reconsideration of the necessary conditions are required in the present guidelines.
