Tokyo Guidelines 2018: management strategies for gallbladder drainage in patients with acute cholecystitis (with videos)

Yasuhisa Mori, Takao Itoi, Todd H. Baron, Tadahiro Takada, Steven M. Strasberg, Henry A. Pitt, Tomohiko Ukai, Satoru Shikata, Yoshinori Noguchi, Anthony Yuen Bun Teoh, Myung Hwan Kim, Horacio J. Asbun, Itaru Endo, Masamichi Yokoe, Fumihiko Miura, Kohji Okamoto, Kenji Suzuki, Akiko Umezawa, Yukio Iwashita, Taizo HibiGo Wakabayashi, Ho Seong Han, Yoo Seok Yoon, In Seok Choi, Tsann Long Hwang, Miin Fu Chen, O. James Garden, Harjit Singh, Kui Hin Liau, Wayne Shih Wei Huang, Dirk J. Gouma, Giulio Belli, Christos Dervenis, Eduardo de Santibañes, Mariano Eduardo Giménez, John A. Windsor, Wan Yee Lau, Daniel Cherqui, Palepu Jagannath, Avinash Nivritti Supe, Keng Hao Liu, Cheng Hsi Su, Daniel J. Deziel, Xiao Ping Chen, Sheung Tat Fan, Chen Guo Ker, Eduard Jonas, Robert Padbury, Shuntaro Mukai, Goro Honda, Atsushi Sugioka, Koji Asai, Ryota Higuchi, Keita Wada, Masahiro Yoshida, Toshihiko Mayumi, Koichi Hirata, Yoshinobu Sumiyama, Kazuo Inui, Masakazu Yamamoto

Research output: Contribution to journalArticlepeer-review

62 Citations (Scopus)

Abstract

Since the publication of the Tokyo Guidelines in 2007 and their revision in 2013, appropriate management for acute cholecystitis has been more clearly established. Since the last revision, several manuscripts, especially for alternative endoscopic techniques, have been reported; therefore, additional evaluation and refinement of the 2013 Guidelines is required. We describe a standard drainage method for surgically high-risk patients with acute cholecystitis and the latest developed endoscopic gallbladder drainage techniques described in the updated Tokyo Guidelines 2018 (TG18). Our study confirmed that percutaneous transhepatic gallbladder drainage should be considered the first alternative to surgical intervention in surgically high-risk patients with acute cholecystitis. Also, endoscopic transpapillary gallbladder drainage or endoscopic ultrasound-guided gallbladder drainage can be considered in high-volume institutes by skilled endoscopists. In the endoscopic transpapillary approach, either endoscopic naso-gallbladder drainage or gallbladder stenting can be considered for gallbladder drainage. We also introduce special techniques and the latest outcomes of endoscopic ultrasound-guided gallbladder drainage studies. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.

Original languageEnglish
Pages (from-to)87-95
Number of pages9
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume25
Issue number1
DOIs
Publication statusPublished - Jan 2018
Externally publishedYes

Keywords

  • Acute cholecystitis
  • Endoscopic transpapillary gallbladder drainage
  • Endoscopic ultrasound-guided gallbladder drainage
  • Gallbladder drainage
  • Percutaneous transhepatic gallbladder drainage

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