分级(工程)
医学
急性胆囊炎
胆囊炎
重症监护医学
诊断准确性
临床实习
普通外科
外科
内科学
物理疗法
胆囊切除术
胆囊
工程类
土木工程
作者
Masamichi Yokoe,Jiro Hata,Tadahiro Takada,Steven M. Strasberg,Horacio J. Asbun,Go Wakabayashi,Kazuto Kozaka,Itaru Endo,Daniel J. Deziel,Fumihiko Miura,Kohji Okamoto,Tsann‐Long Hwang,Wayne Shih‐Wei Huang,Chen‐Guo Ker,Miin‐Fu Chen,Ho‐Seong Han,Yoo‐Seok Yoon,In‐Seok Choi,Dong Sup Yoon,Yoshinori Noguchi
摘要
Abstract The Tokyo Guidelines 2013 (TG13) for acute cholangitis and cholecystitis were globally disseminated and various clinical studies about the management of acute cholecystitis were reported by many researchers and clinicians from all over the world. The 1 st edition of the Tokyo Guidelines 2007 ( TG 07) was revised in 2013. According to that revision, the TG 13 diagnostic criteria of acute cholecystitis provided better specificity and higher diagnostic accuracy. Thorough our literature search about diagnostic criteria for acute cholecystitis, new and strong evidence that had been released from 2013 to 2017 was not found with serious and important issues about using TG 13 diagnostic criteria of acute cholecystitis. On the other hand, the TG 13 severity grading for acute cholecystitis has been validated in numerous studies. As a result of these reviews, the TG 13 severity grading for acute cholecystitis was significantly associated with parameters including 30‐day overall mortality, length of hospital stay, conversion rates to open surgery, and medical costs. In terms of severity assessment, breakthrough and intensive literature for revising severity grading was not reported. Consequently, TG 13 diagnostic criteria and severity grading were judged from numerous validation studies as useful indicators in clinical practice and adopted as TG 18/ TG 13 diagnostic criteria and severity grading of acute cholecystitis without any modification. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47 . Related clinical questions and references are also included.
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