2022 Volume 36 Issue 2 Pages 106-112
Evidences reported after Tokyo Guidelines 2018 was published are introduced. A study using the data of national clinical database (NCD) in 2018 revealed that 90-day mortality after cholecystectomy was 0.6%. A population-based propensity score analysis performed in Canada comparing operative outcomes between early and delayed cholecystectomy for acute cholecystitis was published. Early cholecystectomy was associated with a lower risk of major bile duct injury. There was not a high level of evidence regarding PTGBD. Randomized controlled trial performed in the Netherlands demonstrated that there had not been significant difference in mortality rates between the PTGBD group and the laparoscopic cholecystectomy group although recurrent biliary disease and major complications occurred more often in the PTGBD group. It is to be desired that a physician selects the therapeutic strategy for acute cholecystitis according to a patient's status and a condition of each institution.
