Implementation of the Tokyo 2018 guides criteria to patients with acute cholecystitis
Keywords:
colecistitis aguda, guías de Tokio, colecistectomía, grado de severidadAbstract
Introduction: The publication of 2007 (updated in 2013 and 2018) of Tokyo guides for acute cholecystitis, aimes at unifying diagnostic criteria and classifying patients according to their seriousness, to facilitate the decisions making and their later analysis.
Objective: To evaluate the criteria assumed by Tokyo guides in patients operated due to acute cholecystitis.
Methods: An observational descriptive study was carried out in 450 patients operated due to acute cholecystitis in the general surgery service of Saturnino Lora Hospital of Santiago de Cuba since 2019 to 2022.
Results: The results of the study carried out in 450 patients by means of the digital medical images was a frequent edema in the wall. According to the criteria of seriousness 270 patients are identified in grade I with (60.0%), in the grade II 167 (37.1%) and in grade III 13 (2.9%). The surgical findings were 55.8% for the edematous form, followed with 24.4% for the suppurative, 17.8 % gangrenous and 2.0 % perforated form. Twelve patients died for 2.7% of the series.
Conclusions: The Tokyo guides for acute cholecystitis according to the pattern severity establish a model for the opportune treatment, as well as the clinical correlation, with complementary exams, operative findings and final clinical course of patients, once that most of the deceaseds fit with the most severe forms of the affection.
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1. Martínez Martínez S, Brea Sánchez M, Romero Gordo L. Influencia de los hallazgos ecográficos en el abordaje terapéutico de la colecistitis aguda: un estudio retrospectivo. Archivos de Medicina Universitaria. 2023[citado: 03/11/2023]; 5(1):34-43. Disponible en: https://digibug.ugr.es/bitstream/handle/10481/81342/34-43%20Colecistitis.pdf?sequence=3&isAllowed=y
2. Kumar HR. Current Management of Acute Cholecystitis: A Narrative Review. Asian J Med Health. 2024. [citado: 21/04/2024];22(1):57–63. Disponible en: https://journalajmah.com/index.php/AJMAH/article/view/975/1935
3. Rojas Solís PF, Sotelo Casas AY, Aceves Ayala JM. Colecistitis Aguda: Artículo de Revisión. Libr Compil Result Investig. 2022. [citado: 19/02/2024]; Capitulo 7: 139-64. Disponible en: https://www.researchgate.net/publication/365974443_Colecistitis_Aguda_Articulo_De_Revision_Autores
4. Cisneros Carmenate A, Montes de Oca Mastrapa JL, Peña García Y. Factores pronósticos de las complicaciones de la Colecistitis Aguda. En: Convención Internacional de Salud, Cuba Salud 2022. [citado: 12/11/2024]; p. 1–8. Disponible en: https://convencionsalud.sld.cu/index.php/convencionsalud22/2022/paper/viewFile/341/75
5. Yokoe M, Hata J, Takada T, Strasberg SM, Asbun HJ, Wakabayashi G, et al. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis. Journal of Hepato-Biliary-Pancreatic Surg. 2018. [citado 28/11/2023];25(1):41-54. Disponible en: https://onlinelibrary.wiley.com/doi/10.1002/jhbp.515
6. Escartín A, González M, Muriel P, Cuello E, Pinillos A, Santamaría M, et al. Colecistitis aguda litiásica: aplicación de las Guías de Tokio en los criterios de gravedad. Cirugía y Cirujanos. 2021 [citado 07/09/2023];89(1):12–21. Disponible en: https://www.cirugiaycirujanos.com/frame_esp.php?id=434
7. Fagenson AM, Powers BD, Zorbas KA, Karhadkar S, Karachristos A, Di Carlo A, et al. Frailty Predicts Morbidity and Mortality After Laparoscopic Cholecystectomy for Acute Cholecystitis: An ACS-NSQIP Cohort Analysis. J Gastrointest Surg. 2021. [citado 18/04/2024];25(4):932–40. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1091255X2301034X?via%3Dihub .
8. Sapmaz Ali, Karaca Ahmet Serdat. Risk factors for conversion to open surgery in laparoscopic cholecystectomy: a single center experience. Turk J Surg. 2021. [citado 21/04/2024]; 37(1):28–32. Disponible en: https://behmedicalbulletin.org/pdf/1e8a7eae-47cf-4a4e-a540-9cee47620b04/articles/BMB.galenos.2021.04.047/Bagc%C4%B1larMedicalBulletin-6-280-En.pdf
9. World Medical Association. Declaration of Helsinki. Ethical Principles for Medical Research Involving Human Participants. JAMA. 2024 [citado 03/04/2024]; 23(18):e21972. Disponible en: https://jamanetwork.com/journals/jama/fullarticle/2825290
10. Mansilla Sofía, Cubas Santiago, Martínez Marysol, Almada Mario, Machado Fernando, Canessa César. Opciones terapéuticas para la colecistitis aguda: de las guías de Tokio 2018 a la práctica clínica. Rev. Méd. Urug. 2022 [citado 30/11/2023]; 38(3): e206. Disponible en: http://www.scielo.edu.uy/scielo.php?script=sci_arttext&pid=S1688-03902022000301206&lng=es.
11. Chama Naranjo A, Cruz Zárate A, Ruiz Funes AP, Barbosa Villareal F, Farell Rivas J, Cuevas Osorio VJ. ¿Día o noche? El momento ideal para realizar la colecistectomía. Rev Colomb Cir. 2022 [citado16/03/2024];37(4):597–603. Disponible en: https://www.revistacirugia.org/index.php/cirugia/article/view/2139/1812
12. Kumar Naik Tarun, Kumar Khare Manish. A retrospective assessment of the complications and associated risk factors of laparoscopic cholecystectomy. International Journal of Surgery Science. 2021 [citado 10/10/2023];5(1):368–73. https://www.surgeryscience.com/articles/639/5-1-53-530.pdf
13. Magnano San Lio R, Barchitta M, Maugeri A, Quartarone S, Basile G, Agodi A. Preoperative Risk Factors for Conversion from Laparoscopic to Open Cholecystectomy: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2022 [citado 10/10/2023]; 20(1):408. Disponible en: https://europepmc.org/article/med/36612732 .
14. Estepa Pérez JL, Santana Pedraza T, Estepa Ramos JL, Feliú Rosa JA. Caracterización clínico quirúrgica de la colecistitis aguda en pacientes tratados en el Servicio de Cirugía General. Cienfuegos, 2017- 2019. Medisur. 2023. [citado 24/03/2024]; 21(2):400-411. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1727-897X2023000200400&lng=es. .
15. Morales Maza J, Rodríguez Quintero JH, Santes O, Aguilar Frasco JL, Romero Vélez G, García Ramos ES, et al. Conversión de colecistectomía laparoscópica a abierta: análisis de factores de riesgo con base en parámetros clínicos, de laboratorio y de ultrasonido. Revista de Gastroenterología de México. 2021 [citado 16/02/2023];86(4):363–9. Disponible en: https://www.sciencedirect.com/science/article/pii/S0375090620301312?via%3Dihub
16. Salazar Flores DC, Luna Cydejko JC, Nieto Yrigoin KA. Características clínicas y quirúrgicas de los pacientes con diagnóstico de colecistitis aguda sometidos a colecistectomía en la Clínica Internacional Sede San Borja en el 2019-2020. Interciencia Médica. 2024. [citado 01/04/2024];14(1):13–25. Disponible en: https://www.researchgate.net/publication/379490772_Caracteristicas_clinicas_y_quirurgicas_de_los_pacientes_con_diagnostico_de_colecistitis_aguda_sometidos_a_colecistectomia_en_la_Clinica_Internacional_Sede_San_Borja_en_el_2019-2020
17. Chen J, Gao Q, Huang X, Wang Y. Prognostic clinical indexes for prediction of acute gangrenous cholecystitis and acute purulent cholecystitis. BMC Gastroenterol. 2022. [citado10/10/2023];22:491-8. Disponible en: https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-022-02582-6
18. Calle Jara EF, Idrovo Campoverde PJ, Peralta Sánchez AG, Bermeo León KJ, Quilli Guaman JJ. Colecistitis aguda alitiásica. 2022. [citado 09/02/2024];6(2):520–6. Disponible en: https://recimundo.com/index.php/es/article/view/1593/2052
19. Chang Yau-Ren, Wu Yu-Tung, Chen Szu-An, Fu Chih-Yuan, Hsu Chih-Po, Cheng Chi-Tung et al. Management of acute cholecystitis in patients older than the expected life expectancy: Is the Tokio Guidelines 2018 still practical? Research Square
2024. [citado 02/02/2024]. Preprint. Disponible en: https://www.researchgate.net/publication/378358101_Management_of_acute_cholecystitis_in_patients_older_than_the_expected_life_expectancy_Is_the_Tokyo_Guidelines_2018_still_practical .
20. González-Castillo AM, Sancho-Insenser J, De Miguel-Palacio M, Morera-Casaponsa JR, Membrilla-Fernández E, Pons-Fragero MJ, et al. Mortality risk estimation in acute calculous cholecystitis: beyond the Tokio Guidelines. World Journal Emergency Surgery. 2021. [citado12/04/2024];16(1):24. Disponible en: https://wjes.biomedcentral.com/articles/10.1186/s13017-021-00368-x
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