Choosing the Best Timing for Cholecystectomy
In TG18, the selection of treatment strategy at each severity grade of AC is based on predictive factors, CCI score, and ASA-PS score. Laparoscopic cholecystectomy to treat Grade II (moderate) and Grade III (severe) AC should be performed only at advanced centers and by experienced surgeons, in addition to the conditions described in the TG18 treatment flowcharts. If the patient is not considered suitable for early surgery, TG18 recommends early/urgent biliary drainage followed by delayed surgery once the patient’s overall condition has improved. TG18 treatment flowcharts were aimed at improving the percentage of lives saved by allowing doctors to determine how to safely treat AC through the use of decision-making criteria.
KeywordsAcute cholecystitis Laparoscopic cholecystectomy Tokyo Guidelines Predictive factors Charlson Comorbidity Index (CCI) American Society of Anesthesiologist physical status classification (ASA) Biliary drainage
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