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Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines |
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| Authors: | Yuichi Yamashita Tadahiro Takada Yoshifumi Kawarada Yuji Nimura Masahiko Hirota Fumihiko Miura Toshihiko Mayumi Masahiro Yoshida Steven Strasberg Henry A. Pitt Eduardo de Santibanes Jacques Belghiti Markus W. Büchler Dirk J. Gouma Sheung-Tat Fan Serafin C. Hilvano Joseph W.Y. Lau Sun-Whe Kim Giulio Belli John A. Windsor Kui-Hin Liau Vibul Sachakul |
| Affiliation: | Department of Surgery, Fukuoka University Hospital, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan Mie University School of Medicine, Mie, Japan Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Science, Kumamoto, Japan Department of Emergency Medicine and Critical Care, Nagoya University School of Medicine, Nagoya, Japan Washington University in St Louis and Barnes-Jewish Hospital, St Louis, USA Department of Surgery, Indiana University School of Medicine, Indianapolis, USA Department of Surgery, University of Buenos Aires, Buenos Aires, Argentina Hepatobiliopancreatic Surgery and Liver Transplantation, Hospital Beaujon, Clichy, France Department of Surgery, University of Heidelberg, Heidelberg, Germany G4-116, Academic Medical Center, Amsterdam, The Netherlands Department of Surgery, The University of Hong Kong, Pokfulam, Hong Kong, China Department of Surgery, Philippine General Hospital, University of the Philippines, Manila, Philippines Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China Department of Surgery, Seoul National University College of Medicine, Seoul, Korea General and HPB Surgery, Loreto Nuovo Hospital, Naples, Italy Department of Surgery, The University of Auckland, Auckland, New Zealand Department of Surgery, Tan Tock Seng Hospital / Hepatobiliary Surgery, Medical Centre, Singapore, Singapore Department of Surgery, Phramongkutklao Hospital, Bangkok, Thailand |
| Abstract: | Cholecystectomy has been widely performed in the treatment of acute cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute cholecystitis in a question-and-answer format. |
| Keywords: | Acute cholecystitis Cholecystectomy Laparoscopic cholecystectomy Open surgery Cholecystostomy Guidelines |
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