Acute cholecystitis severity (Tokyo 2018)
Classifies already-diagnosed acute cholecystitis as mild, moderate or severe based on organ dysfunction or major local inflammation and summarizes Tokyo Guidelines 2018 management.
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Method · Limits of application
Tokyo Guidelines 2018/Yokoe (TG13 criteria retained): severity I–III; any of the 6 organ dysfunctions defines III; in their absence, any of the 4 moderate criteria defines II
The TG18/TG13 edition retains the previous diagnostic and severity criteria. Classification requires their complete clinical and laboratory definitions; the management document has additional conditions and must be considered separately, without deriving a course of action solely from the category. In TG18 Table 7, grade II requires any of the four listed criteria, provided there is no grade III dysfunction; it is not limited to marked local inflammation. This review tests already checked findings in previously diagnosed cholecystitis. It does not test the clinical assignment of findings, laboratory thresholds, diagnostic eligibility or management.
Conditions of use
Check the population, units, inclusion and exclusion criteria, and version in the original source. A result alone does not establish a diagnosis, discharge decision or prescription.
Documented parameters
- Grade III · Cardiovascular: hypotension requiring dopamine ≥ 5 µg/kg/min or any dose of norepinephrine
- Grade III · Neurological: reduced level of consciousness
- Grade III · Respiratory: PaO₂/FiO₂ < 300
- Grade III · Renal: oliguria or creatinine > 2.0 mg/dL
- Grade III · Hepatic: INR > 1.5
- Grade III · Hematologic: platelets < 100,000/mm³
- Grade II · Leukocytes > 18,000/mm³
- Grade II · Palpable tender mass in the right upper quadrant
- Grade II · Symptoms for more than 72 hours
- Grade II · Marked local inflammation (gangrene, pericholecystic or hepatic abscess, biliary peritonitis, emphysematous cholecystitis)
4/4 reference cases checked. Numerical tests are not clinical validation.
Relationship with cancer research
General context — relationship to be defined
A resource for general clinical contexts. This edition does not assign a specific oncological relationship; selecting it for a study requires a justified question, population and purpose.