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ISSN 2007-6517 (Print)

2013, Number 1

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Rev Latinoam Cir 2013; 3 (1)

Tokyo's clinical criteria correlation with histopathological examination of the surgical specimen for the diagnosis of acute cholecystitis

Salinas-González CA, Pereyra-Nobara TA, Evangelista-Nava C, Salinas GMÁ, Palomares-Chacón UR, Pérez-Navarro JV, Anaya-Prado R, González-Izquierdo JJ

Language: Spanish
References: 21
Page: 16-19
PDF size: 220.97 Kb.


ABSTRACT

Introduction: In 2006, the Tokyo Guidelines for the Management of Acute Cholangitis and Cholecystitis were issued as an outcome of the Tokio Consensus Meeting. Despite their usefulness and continuous updating (2013 version), they are still little known in our field. The purpose of this study is to determine the usefulness of the Tokyo Guidelines for the diagnosis of acute cholecystitis, compared to the histopathological results.
Material and methods: This is a cross-sectional study. We included emergency patients seen for presenting clinical picture of acute cholecystitis; they were classified according to the Tokyo Guidelines by surgeon other than the one who performed the cholecystectomy. All patients underwent cholecystectomy and the gallbladder extracted was sent to be studied by an expert pathologist also blinded to the results of the preoperative Tokyo criteria.
Results: Forty-eight patients were enrolled during the period of study. For the analysis of the diagnostic test, the microscopic description was taken as a definitive diagnosis of acute cholecystitis, finding a sensitivity of 0.97 (97%), with a specificity of 0.88 (88%), a positive predictive value of 0.97 (97%) and a negative predictive value of 0.88 (88%); positive likelihood ratio of 8.8 and negative likelihood ratio of 0.02.
Conclusions: The Tokyo Guidelines can be used safely and their use as a diagnostic standard for acute cholecystitis in patients suspected of having this disease must be encouraged.


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