Abstract
In this study we aimed to retrospectively validate the diagnostic criteria and severity grading for acute cholecystitis (the updated Tokyo Guidelines; TG13) in our daily clinical setting. We enrolled 65 cases with acute cholecystitis as final diagnosis admitted to our department between January 2010 and August 2012. On admission, 60, 62, and 59 patients satisfied each criterion of TG13; local signs of inflammation, systemic signs of inflammation, and imaging findings, respectively. As a result, 58 (89%) and 53 (82%) were diagnosed as suspected and definite diagnosis on admission. Among 7 patients who did not satisfy diagnostic criteria on admission, 4 were diagnosed as acute cholecystitis (suspected; 1, definite; 5) with inclusion of clinical signs before/after admission. Thus 62 (95%) and 56 (86%) were finally diagnosed as suspected and definite with this modifications. As for severity grading, 15 and 50 patients were graded as mild and moderate. Admission period was significantly longer and gallbladder drainage was performed more frequently in moderate cases compared to mild cases. In conclusion, the TG13 for acute cholecystitis was well validated in cases of our department.
