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Article: New diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo guidelines

TitleNew diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo guidelines
Authors
KeywordsAcute Cholecystitis
Diagnostic Criteria
Guidelines
Murphy's Sign
Severity Assessment
Issue Date2012
PublisherSpringer Japan KK. The Journal's web site is located at http://www.springer.com/medicine/surgery/journal/534
Citation
Journal Of Hepato-Biliary-Pancreatic Sciences, 2012, v. 19 n. 5, p. 578-585 How to Cite?
AbstractBackground: The Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) were published in 2007 as the world's first guidelines for acute cholangitis and cholecystitis. The diagnostic criteria and severity assessment of acute cholecystitis have since been widely used all over the world. A validation study of TG07 has shown that the diagnostic criteria for acute cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. In addition, considerable new evidence referring to acute cholecystitis as well as evaluations of TG07 have been published. Consequently, we organized the Tokyo Guidelines Revision Committee to evaluate TG07, recognize new evidence, and conduct a multi-center analysis to revise the guidelines (TG13). Methods and materials: We retrospectively analyzed 451 patients with acute cholecystitis from multiple tertiary care centers in Japan. All 451 patients were first evaluated using the criteria in TG07. The "gold standard" for acute cholecystitis in this study was a diagnosis by pathology. The validity of TG07 diagnostic criteria was investigated by comparing clinical with pathological diagnosis. Results: Of 451 patients evaluated, a total of 227 patients were given a diagnosis of acute cholecystitis by pathological examination (prevalence 50.3 %). TG07 criteria provided a definite diagnosis of acute cholecystitis in 224 patients. The sensitivity of TG07 diagnostic criteria for acute cholecystitis was 92.1 %, and the specificity was 93.3 %. Based on the preliminary results, new diagnostic criteria for acute cholecystitis were proposed. Using the new criteria, the sensitivity of definite diagnosis was 91.2 %, and the specificity was 96.9 %. The accuracy rate was improved from 92.7 to 94.0 %. In regard to severity grading among 227 patients, 111 patients were classified as Mild (Grade I), 104 as Moderate (Grade II), and 12 as Severe (Grade III). Conclusion: The proposed new diagnostic criteria achieved better performance than the diagnostic criteria in TG07. Therefore, the proposed criteria have been adopted as new diagnostic criteria for acute cholecystitis and are referred to as the 2013 Tokyo Guidelines (TG13). Regarding severity assessment, no new evidence was found to suggest that the criteria in TG07 needed major adjustment. As a result, TG07 severity assessment criteria have been adopted in TG13 with minor changes. © 2012 The Author(s).
Persistent Identifierhttp://hdl.handle.net/10722/173038
ISSN
2015 Impact Factor: 3.146
2015 SCImago Journal Rankings: 1.446
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorYokoe, Men_US
dc.contributor.authorTakada, Ten_US
dc.contributor.authorStrasberg, SMen_US
dc.contributor.authorSolomkin, JSen_US
dc.contributor.authorMayumi, Ten_US
dc.contributor.authorGomi, Hen_US
dc.contributor.authorPitt, HAen_US
dc.contributor.authorGouma, DJen_US
dc.contributor.authorGarden, OJen_US
dc.contributor.authorBüchler, MWen_US
dc.contributor.authorKiriyama, Sen_US
dc.contributor.authorKimura, Yen_US
dc.contributor.authorTsuyuguchi, Ten_US
dc.contributor.authorItoi, Ten_US
dc.contributor.authorYoshida, Men_US
dc.contributor.authorMiura, Fen_US
dc.contributor.authorYamashita, Yen_US
dc.contributor.authorOkamoto, Ken_US
dc.contributor.authorGabata, Ten_US
dc.contributor.authorHata, Jen_US
dc.contributor.authorHiguchi, Ren_US
dc.contributor.authorWindsor, JAen_US
dc.contributor.authorBornman, PCen_US
dc.contributor.authorFan, STen_US
dc.contributor.authorSingh, Hen_US
dc.contributor.authorDe Santibanes, Een_US
dc.contributor.authorKusachi, Sen_US
dc.contributor.authorMurata, Aen_US
dc.contributor.authorChen, XPen_US
dc.contributor.authorJagannath, Pen_US
dc.contributor.authorLee, Sen_US
dc.contributor.authorPadbury, Ren_US
dc.contributor.authorChen, MFen_US
dc.date.accessioned2012-10-30T06:26:52Z-
dc.date.available2012-10-30T06:26:52Z-
dc.date.issued2012en_US
dc.identifier.citationJournal Of Hepato-Biliary-Pancreatic Sciences, 2012, v. 19 n. 5, p. 578-585en_US
dc.identifier.issn1868-6974en_US
dc.identifier.urihttp://hdl.handle.net/10722/173038-
dc.description.abstractBackground: The Tokyo Guidelines for the management of acute cholangitis and cholecystitis (TG07) were published in 2007 as the world's first guidelines for acute cholangitis and cholecystitis. The diagnostic criteria and severity assessment of acute cholecystitis have since been widely used all over the world. A validation study of TG07 has shown that the diagnostic criteria for acute cholecystitis are highly reliable but that the definition of definite diagnosis is ambiguous. In addition, considerable new evidence referring to acute cholecystitis as well as evaluations of TG07 have been published. Consequently, we organized the Tokyo Guidelines Revision Committee to evaluate TG07, recognize new evidence, and conduct a multi-center analysis to revise the guidelines (TG13). Methods and materials: We retrospectively analyzed 451 patients with acute cholecystitis from multiple tertiary care centers in Japan. All 451 patients were first evaluated using the criteria in TG07. The "gold standard" for acute cholecystitis in this study was a diagnosis by pathology. The validity of TG07 diagnostic criteria was investigated by comparing clinical with pathological diagnosis. Results: Of 451 patients evaluated, a total of 227 patients were given a diagnosis of acute cholecystitis by pathological examination (prevalence 50.3 %). TG07 criteria provided a definite diagnosis of acute cholecystitis in 224 patients. The sensitivity of TG07 diagnostic criteria for acute cholecystitis was 92.1 %, and the specificity was 93.3 %. Based on the preliminary results, new diagnostic criteria for acute cholecystitis were proposed. Using the new criteria, the sensitivity of definite diagnosis was 91.2 %, and the specificity was 96.9 %. The accuracy rate was improved from 92.7 to 94.0 %. In regard to severity grading among 227 patients, 111 patients were classified as Mild (Grade I), 104 as Moderate (Grade II), and 12 as Severe (Grade III). Conclusion: The proposed new diagnostic criteria achieved better performance than the diagnostic criteria in TG07. Therefore, the proposed criteria have been adopted as new diagnostic criteria for acute cholecystitis and are referred to as the 2013 Tokyo Guidelines (TG13). Regarding severity assessment, no new evidence was found to suggest that the criteria in TG07 needed major adjustment. As a result, TG07 severity assessment criteria have been adopted in TG13 with minor changes. © 2012 The Author(s).en_US
dc.languageengen_US
dc.publisherSpringer Japan KK. The Journal's web site is located at http://www.springer.com/medicine/surgery/journal/534en_US
dc.relation.ispartofJournal of Hepato-Biliary-Pancreatic Sciencesen_US
dc.subjectAcute Cholecystitisen_US
dc.subjectDiagnostic Criteriaen_US
dc.subjectGuidelinesen_US
dc.subjectMurphy's Signen_US
dc.subjectSeverity Assessmenten_US
dc.titleNew diagnostic criteria and severity assessment of acute cholecystitis in revised Tokyo guidelinesen_US
dc.typeArticleen_US
dc.identifier.emailFan, ST: stfan@hku.hken_US
dc.identifier.authorityFan, ST=rp00355en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1007/s00534-012-0548-0en_US
dc.identifier.pmid22872303-
dc.identifier.scopuseid_2-s2.0-84867330001en_US
dc.identifier.hkuros211036-
dc.identifier.volume19-
dc.identifier.issue5-
dc.identifier.spage578en_US
dc.identifier.epage585en_US
dc.identifier.isiWOS:000312153300011-
dc.publisher.placeJapanen_US
dc.identifier.scopusauthoridYokoe, M=35204159000en_US
dc.identifier.scopusauthoridTakada, T=7202751961en_US
dc.identifier.scopusauthoridStrasberg, SM=7101931401en_US
dc.identifier.scopusauthoridSolomkin, JS=7006149016en_US
dc.identifier.scopusauthoridMayumi, T=7102413301en_US
dc.identifier.scopusauthoridGomi, H=15836576100en_US
dc.identifier.scopusauthoridPitt, HA=7103213587en_US
dc.identifier.scopusauthoridGouma, DJ=36046572200en_US
dc.identifier.scopusauthoridGarden, OJ=7006432342en_US
dc.identifier.scopusauthoridBüchler, MW=35277875400en_US
dc.identifier.scopusauthoridKiriyama, S=26643310800en_US
dc.identifier.scopusauthoridKimura, Y=7403990474en_US
dc.identifier.scopusauthoridTsuyuguchi, T=6701437594en_US
dc.identifier.scopusauthoridItoi, T=7006598184en_US
dc.identifier.scopusauthoridYoshida, M=14421962900en_US
dc.identifier.scopusauthoridMiura, F=35475649700en_US
dc.identifier.scopusauthoridYamashita, Y=7402954641en_US
dc.identifier.scopusauthoridOkamoto, K=55317449700en_US
dc.identifier.scopusauthoridGabata, T=35451751500en_US
dc.identifier.scopusauthoridHata, J=35396396800en_US
dc.identifier.scopusauthoridHiguchi, R=55317433500en_US
dc.identifier.scopusauthoridWindsor, JA=16173985400en_US
dc.identifier.scopusauthoridBornman, PC=7006718164en_US
dc.identifier.scopusauthoridFan, ST=7402678224en_US
dc.identifier.scopusauthoridSingh, H=55317409300en_US
dc.identifier.scopusauthoridde Santibanes, E=15057704700en_US
dc.identifier.scopusauthoridKusachi, S=7005805567en_US
dc.identifier.scopusauthoridMurata, A=8867169200en_US
dc.identifier.scopusauthoridChen, XP=55043884000en_US
dc.identifier.scopusauthoridJagannath, P=7003575736en_US
dc.identifier.scopusauthoridLee, S=25927169100en_US
dc.identifier.scopusauthoridPadbury, R=6603924012en_US
dc.identifier.scopusauthoridChen, MF=34874546600en_US

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