| [ Summary ] |
Acute cholecystitis should be suspected when Murphy's sign, local inflammatory findings in the gallbladder such as right upper quadrant abdominal pain and tenderness, and fever and systemic inflammatory reaction findings are detected in blood tests. Tokyo Guidelines 2013 (TG13) presents new standards for the diagnosis, severity grading, and management of acute cholecystitis. Moreover, TG13 has adopted the management bundles for acute cholecystitis. Critical parts of the bundles in TG13 include diagnostic process, severity assessment, transfer of patients if necessary, therapeutic approach, and time course. Observance of these critical parts should improve the prognosis of acute cholecystitis. When utilizing TG13 management bundles, further clinical research needs to be conducted to evaluate their effectiveness and outcomes. We expect that the present report will lead to evidence construction and contribute to further updating of the Tokyo Guidelines. |