Problems of classification of acute cholecystitis and ways to solve them
https://doi.org/10.25789/YMJ.2024.85.25
Abstract
Acute cholecystitis undoubtedly remains an urgent problem of urgent abdominal surgery. The incidence of this nosology is 160 thousand cases per year. Postoperative mortality is in the range of 1,2-1,4%. Currently, the classification of acute cholecystitis, which is based on the Tokyo agreements, has received active distribution and use. However, this classification does not allow us to determine the degree of destructive process in the wall of the gallbladder. This often leads to a prolongation of the duration of conservative therapy and an increase in the percentage of intraoperative and postoperative complications. In this publication, we have tried to characterize the available classifications of acute cholecystitis, taking into account the advantages and disadvantages. And also, to propose a more rational classification from the point of view of a practical surgeon.
About the Authors
A. A. Yashnov
HBO in CHMA
Russian Federation
Russian Federation
YASHNOV Alexey Alexandrovich – MD; Associate Professor of Cadre of the Faculty of Surgery with the course of cadre
M. M. Vinokurov
Federal State Budgetary Educational Institution of Higher Education
Russian Federation
Russian Federation
VINOKUROV Mikhail Mikhailovich – MD, Professor; Head of the Department of Faculty Surgery, Urology, Oncology and Otolaryngology; Academician of the Academy of Sciences of the Republic of Sakha (Yakutia)
O. G. Konovalova
URO HBO in CHMA
Russian Federation
Russian Federation
KONOVALOVA Olga Gennadievna – Candidate of Medical Sciences, Associate Professor of human resources with the course
N. B. Yashnova
CHSBI CHMA
Russian Federation
Russian Federation
YASHNOVA Nadezhda Borisovna – assistant of the Depart- ment of Neurology with the course
References
1. Bautkin, A.V., Cherkasov M.F., Eleev A.A. Problema intra-i posleoperatsionnykh oslozhnenii pri lechenii ostrogo kal'kuleznogo kholetsistita i sposoby ikh profilaktiki [The problem of intraand postoperative complications in the treatment of acute calculous cholecystitis and methods of their prevention]. Meditsinskii vestnik Yuga Rossii [Medical Bulletin of the South of Russia. 2012; 3: 4-6 (In Russ.).]
2. Beburishvili A.G. Zhelchnaya gipertenziya i ostryi kholetsistit [Biliary hypertension and acute cholecystitis]. 80 lektsii po khirurgii pod redaktsiei V.S. Savelieva [80 lectures on surgery edited by V.S. Savelyev. Moscow: Litera, 2008; 388-400 (In Russ.).]
3. Egorova E.A. [et al.] Vozmozhnosti luchevykh metodov v diagnostike oslozhnennykh form kholetsistita (obzor literatury i klinicheskie nablyudeniya) [The possibilities of radiation methods in the diagnosis of complicated forms of cholecystitis (literature review and clinical observations). Radiologiya-praktika [Radiology practice. 2016; 5:26–41 (In Russ.).]
4. Kossovich M.A. [et al.] Vybor optimal'nykh srokov vypolneniya operativnogo vmeshatel'stva pri ostrom kal'kuleznom kholetsistite [Choosing the optimal timing of surgical intervention in acute calculous cholecystitis]. Khirurgiya. Zhurnal im. Pirogova [Surgery. Pirogov Journal. 2020; 3: 56-60 (In Russ.).] https://doi.org/10.17116/hirurgia202003156.
5. Koishibaeva L.M., Turgunov E.M., Sukhanova A.A. Sravnenie urovnya kachestva zhizni patsientov do i cherez 6 mesyatsev posle kholetsistehktomii [Comparison of the quality of life of patients before and 6 months after cholecystectomy]. Meditsinskii zhurnal Zapadnogo Kazakhstana [Medical Journal of Western Kazakhstan. 2018; 1(57): 52-57 (In Russ.).]
6. Kudryavtseva A.V. Komp'yuterno-tomograficheskaya diagnostika ostrogo kholetsistita [Computed tomographic diagnostics of acute cholecystitis]. Congress of the Russian Society of Radiologists and Radiologists [Kongress rossiiskogo obshchestva rentgenologov i radiologov. Moskva. 2019; 101–102 (In Russ.).]
7. Borodetsky B.M. [et al.]. Magnitno-rezonansnaya kholangiopankreatografiya v klinicheskoi praktike. Sravnitel'naya otsenka luchevykh metodov diagnostiki i vliyanie magnitno-rezonansnoi kholangiopankreatografii na taktiku vedeniya patsienta v statsionare [Magnetic resonance cholangiopancreatography in clinical practice. Comparative evaluation of radiation diagnostic methods and the influence of magnetic resonance cholangiopancreatography on the tactics of patient management in the hospital]. Rossiiskii ehlektronnyi zhurnal luchevoi diagnostiki [Russian Electronic Journal of Radiation Diagnostics. 2016; 6 (1): 48-54 (In Russ.).] https://doi.org/10.18411/a-2016-005.
8. Malakhova I.G., Shklyaev A.E., Utkin I.Yu. Ostryi kholangit, oslozhnennyi biliarnym sepsisom: klinicheskii sluchai s blagopriyatnym [Acute cholangitis complicated by biliary sepsis: a clinical case with a favorable]. Arkhiv" vnutrennei meditsiny [Archive of Internal Medicine. 2016; 6 (4): 65-69 (In Russ.).] https://doi.org/10.20514/2226-6704-2016-6-4-65-69.
9. Makhmadov F.I., Karimov P.S., Mirbegiev D., Makhmaderov H.S. K voprosu o kholetsistehtomii pri ostrom kal'kuleznom kholetsistite u bol'nykh s vysokim operatsionno-anesteziologicheskim riskom [On the issue of cholecystectomy in acute calculous cholecystitis in patients with high surgical and anesthetic risk]. Vestnik Akademii meditsinskikh nauk Tadzhikistana [Bulletin of the Academy of Medical Sciences of Tajikistan. 2019; 9; 1(29): 40-46 (In Russ.).] https://doi.org/10.31712/2221-7355-2019-9-140-46.
10. Natroshvili I.G., Prudkov M.I. Naskol'ko aktivnoi dolzhna byt' khirurgicheskaya taktika u bol'nykh ostrym kholetsistitom (po rezul'tatam prospektivnogo mnogotsentrovogo issledovaniya) [How active should surgical tactics be in patients with acute cholecystitis (according to the results of a prospective multicenter study). Vestnik Rossiiskogo universiteta druzhby narodov. Seriya: Meditsina [Bulletin of the Peoples' Friendship University of Russia. Series: Medicine. 2019; 23(2): 156-167 (In Russ.).] https://doi.org/10.22363/2313-02452019-23-2-156-167.
11. Beburishvili A.G. [et al.]. Natsional'nye klinicheskie rekomendatsii. Ostryi kholetsistit. Prinyaty na XII S"ezde khirurgov Rossii «Aktual'nye voprosy khirurgiI» (g. Rostov-na-Donu, 7-9 oktyabrya 2015 g.) [National clinical guidelines. Acute cholecystitis. Adopted at the XII Congress of Surgeons of Russia "Topical issues of surgery" (Rostov-on-Don, October 7-9, 2015). Moscow. 2015: 20 (In Russ.).]
12. Buriev I.M. [et al.]. Ul'trazvukovaya i kliniko-laboratornaya diagnostika istinnykh morfologicheskikh form ostrogo kholetsistita: neobkhodimost' smeny klassifikatsii [Ultrasound and clinical and laboratory diagnostics of true morphological forms of acute cholecystitis: the need to change the classification]. Annaly khirurgicheskoi gepatologii [Annals of surgical hepatology. 2020; 25 (3): 55-62 (In Russ.).] https://doi.org/10.16931/1995-5464.2020355-62.
13. Revishvili A.Sh. [et al.] Khirurgicheskaya pomoshch' v Rossiiskoi Federatsii v period pandemii – osnovnye itogi 2020 goda [Surgical care in the Russian Federation during the pandemic – the main results of 2020]. Khirurgiya. Zhurnal im N.I. Pirogova [Surgery. N.I. Pirogov Journal. 2021; 12: 5-14 (In Russ.).] https://doi.org/10.17116/hirurgia2021 1215.
14. Ambe P.C., Christ H., Wassenberg D. Does the Tokyo guidelines predict the extent of gallbladder inflammation in patients with acute cholecystitis? A single center retrospective analysis. BMC Gastroenterology. 2015; 15(1): 142. https://doi.org/10.1186/s12876-015-0365-4.
15. Cheng W.C. [et al.] Assessing clinical outcomes of patients with acute calculous cholecystitis in addition to the Tokyo grading: A retrospective study. Kaohsiung Journal of Medical Sciences. 2014; 30 (9): 459-465. https://doi.org/j.kjms.2014.05.005.
16. C.S. Loozen [et al.]. Conservative treatment of acute cholecystitis: a systematic review and pooled analysis. Surg Endosc. 2017; 31(2): 504-515. doi: 10.1007/s00464-016-5011-x.
17. Dili A., Bertrand C. Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy. World journal of gastroenterology. 2017; 23 (29): 5438–5450. https://doi.org/10.3748/wjg.v23.i29.5438.
18. Hayasaki A. [et al.] Factor analysis influencing postoperative hospital stay and medical costs for patients with definite, suspected, or unmatched diagnosis of acute cholecystitis according to the Tokyo Guidelines 2013. Gastroenterology Research and Practice. 2016; 2016: 7675953. https://doi.org/10.1155/2016/7675953.
19. Inoue K. [et al.]. Risk factors for difficulty of laparoscopic cholecystectomy in grade II acute cholecystitis according to the Tokyo guidelines 2013. BMC surgery. 2017; 17(1): 114. https://doi.org/10.1186/s12893-017-0319-6.
20. Bouassida M. [et al.] The severity grading of acute cholecystitis following the Tokyo Guidelines is the most powerful predictive factor for conversion from laparoscopic 213 cholecystectomy to open cholecystectomy. Journal of Visceral Surgery. 2017; 154(4): 239–243. https://doi.org/10.1016/j.jviscsurg.2016.11.007.
21. Wakabayashi G. [et al.] Tokyo Guidelines 2018 surgical management of acute cholecystitis: safe steps in laparoscopic cholecystectomy for acute cholecystitis (with videos). Journal of Hepato-Biliary-Pancreatic Sciences. 2018; 25(1): 73–86. https://doi.org/10.1002/jhbp.517.
22. Gomi H. [et al.] Tokyo Guidelines 2018: antimicrobial therapy for acute cholangitis and cholecystitis. J Hepatobiliary Pancreat Sci. 2018; 25: 3–16.
23. Yokoe M. [et al.]. Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholecystitis (with videos). Journal of Hepato-Biliary-Pancreatic Sciences. 2018; 25(1): 41–54. https://doi.org/10.1002/jhbp.515.
24. Okamoto K. [et al.] Tokyo Guidelines 2018: flowchart for the management of acute cholecystitis. Journal of Hepato-Biliary-Pancreatic Sciences. 2018; 25(1): 55–72. https://doi.org/10.1002/jhbp.516.
25. Yokoe M. [et al.] Validation of TG13 severity grading in acute cholecystitis: Japan-Taiwan collaborative study for acute cholecystitis. Journal of HepatoBiliary-Pancreatic Sciences. 2017; 24(6): 338–345. https://doi.org/10.1002/jhbp.457.
Review
For citations:
Yashnov A.A., Vinokurov M.M., Konovalova O.G., Yashnova N.B. Problems of classification of acute cholecystitis and ways to solve them. Yakut Medical Journal. 2024;(1):102-105. https://doi.org/10.25789/YMJ.2024.85.25
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