Surgical treatment of patients with acute cholecystitis: Tokyo guidelines

Yuichi Yamashita, Tadahiro Takada, Yoshifumi Kawarada, Yuji Nimura, Masahiko Hirota, Fumihiko Miura, Toshihiko Mayumi, Masahiro Yoshida, Steven Strasberg, Henry A. Pitt, Eduardo de Santibanes, Jacques Belghiti, Markus W. Büchler, Dirk J. Gouma, Sheung Tat Fan, Serafin C. Hilvano, Joseph W.Y. Lau, Sun Whe Kim, Giulio Belli, John A. WindsorKui Hin Liau, Vibul Sachakul

Research output: Contribution to journalArticlepeer-review

156 Scopus citations


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.

Original languageEnglish
Pages (from-to)91-97
Number of pages7
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Issue number1
StatePublished - Jan 2007


  • Acute cholecystitis
  • Cholecystectomy
  • Cholecystostomy
  • Guidelines
  • Laparoscopic cholecystectomy
  • Open surgery


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