Info

guidelines for the diagnosis and determination of severity of acute cholecystitis

Disease severity:

TG18/TG13 severity grading for acute cholecystitis

  • Grade I
    • Acute cholecystitis in otherwise healthy patient with mild local inflammatory changes and without organ dysfunction
    • Criteria for grade II or III not met
  • Grade II any one of the following characteristics:
    • Leukocytosis (>18,000 cells per mm?)
    • Palpable, tender mass in right upper quadrant
    • Symptom duration >72 hr
    • Marked local inflammation (gangrenous or emphysematous cholecystitis, pericholecystic or hepatic abscess,
    • biliary peritonitis
  • Grade III acute cholecystitis organ dysfunction in any one of the following systems

Figure: 🏞️

Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos) - Yokoe - 2018 - Journal of Hepato-Biliary-Pancreatic Sciences - Wiley Online Library