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Research Paper | Surgery | India | Volume 12 Issue 5, May 2023

Role of Tokyo Guidelines 2018 in Early Laparoscopic Cholecystectomy for Mild and Moderate Acute Calculuscholecystitis

Dr. Nitish S ^[3] | Dr. Kailash Jagannath | Dr Sri Bhargav Kolli

Abstract: Acute calculus cholecystitis (ACC) is the most common complication of gallstone disease and is a very common inflammatory disease of the gallbladder. In recent years, the Tokyo Guidelines 2018 diagnostic criteria and severity grading of acute cholecystitis have become widely established with a reported sensitivity of 91% and specificity of 96%. We aimed to compare the outcomes of patients undergoing early LC for mild and moderate ACC. Based on our findings, we evaluated the feasibility and impact of using TG18 in early LC for mild and moderate ACC. The mean age of the patients was 39.50+14.552 years.69% had grade I ACC and 31% had grade II ACC. LC was converted to a bail - out procedure of LSC and open cholecystectomy in 12% and 2% of the patients respectively. Early surgical complications occurred in 13% patients. The proportion of patients in Grade II ACC had higher degree of bailout procedures, conversion and complications when compared with Grade I ACC (P<0.001). Our study found that using TG18 in early LC for mild and moderate ACC results in acceptable clinical outcomes in a subset of carefully selected patients.

Keywords: Tokyo guidelines, Acute calculous cholecystitis, Early laparoscopic cholecystectomy, Early complications

Edition: Volume 12 Issue 5, May 2023,

Pages: 2040 - 2044