title: Surgical treatment of patients with acute cholecystitis: Tokyo Guidelines.
abstract: Cholecystectomy has been widely performed in the treatment of acute cholecystitis, and laparoscopic cholecystectomy has been increasingly adopted as the method of surgery over the past 15 years. Despite the success of laparoscopic cholecystectomy as an elective treatment for symptomatic gallstones, acute cholecystitis was initially considered a contraindication for laparoscopic cholecystectomy. The reasons for it being considered a contraindication were the technical difficulty of performing it in acute cholecystitis and the development of complications, including bile duct injury, bowel injury, and hepatic injury. However, laparoscopic cholecystectomy is now accepted as being safe for acute cholecystitis, when surgeons who are expert at the laparoscopic technique perform it. Laparoscopic cholecystectomy has been found to be superior to open cholecystectomy as a treatment for acute cholecystitis because of a lower incidence of complications, shorter length of postoperative hospital stay, quicker recuperation, and earlier return to work. However, laparoscopic cholecystectomy for acute cholecystitis has not become routine, because the timing and approach to the surgical management in patients with acute cholecystitis is still a matter of controversy. These Guidelines describe the timing of and the optimal surgical treatment of acute cholecystitis in a question-and-answer format.
authors.affiliation: Department of Surgery, Fukuoka University Hospital, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Kawarada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nimura
authors.forename: Masahiko
authors.initials: M
authors.lastname: Hirota
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miura
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Steven
authors.initials: S
authors.lastname: Strasberg
authors.forename: Henry A
authors.initials: HA
authors.lastname: Pitt
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Santibanes
authors.forename: Jacques
authors.initials: J
authors.lastname: Belghiti
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: Sheung-Tat
authors.initials: ST
authors.lastname: Fan
authors.forename: Serafin C
authors.initials: SC
authors.lastname: Hilvano
authors.forename: Joseph W Y
authors.initials: JW
authors.lastname: Lau
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
authors.forename: Giulio
authors.initials: G
authors.lastname: Belli
authors.forename: John A
authors.initials: JA
authors.lastname: Windsor
authors.forename: Kui-Hin
authors.initials: KH
authors.lastname: Liau
authors.forename: Vibul
authors.initials: V
authors.lastname: Sachakul
mesh_terms: D001652:Bile Ducts / Q000293:injuries; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D041881:Cholecystitis, Acute / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D016032:Randomized Controlled Trials as Topic; D014041:Tokyo; D016896:Treatment Outcome