Janikow Christian, Corti Edgardo, Menso Nicolás, Moretti Gastón, Alé Martín, Sánchez Martín, Lada Paul Eduardo
Surgeon of Urgencies. National Clinic Hospital. Faculty of Medicine. University National of Córdoba. Argentine.
Residents of Urgencies. National Clinic Hospital. Faculty of Medicine. University National of Córdoba. Argentine.
Rev Fac Cien Med Univ Nac Cordoba. 2017;74(2):88-92.
In the year 2007 a group of experts come together to discuss criteria for acute cholecystitis and to establish therapeutic guidelines and states of gravity in this disease.
we correlated the criteria of the Tokyo Guidelines 2007 with the anatomopathology study of the surgical specimen.
Service of Urgencies of the National Clinic Hospital in Córdoba, Argentine.
We studied 324 patients (120 male and 204 female) older than 15 years and without limits of age with the criteria of acute cholecystitis a cord to the Tokyo guidelines 2007. 202 patients had a preoperative diagnosis of chronic cholecystitis and 89 of acute cholecystitis, all received cholecystectomy and studied the operative specimen in the anatomopathology department. Anatomopathology criteria for acute cholecystitis were the presence of polimorpho nuclear cells (PMN), for acute exacerbation of chronic cholecystitis the presence of PMN and monomorpho nuclear cells (MN), and for chronic cholecystitis the presence of MN with or without fibrosis.
This work showed 82,14% of sensitivity for the diagnostic criteria of Tokyo guidelines, 74,03% of specificity, and positive predictive value of 46%. With the Bayes Theorem the predictive value in Córdoba city was 18,49%.
There is an important difference in the specificity and positive predictive value between our work and the Tokyo guidelines for acute cholecystitis. There is an important group of patients in our work with acute exacerbation of chronic cholecystitis that is not classified in the diagnostic criteria for acute cholecystitis of Tokyo guidelines.
2007年，一组专家齐聚一堂，讨论急性胆囊炎的诊断标准，并制定该病的治疗指南和病情严重程度分级。
我们将2007年东京指南的标准与手术标本的解剖病理学研究进行关联。
阿根廷科尔多瓦国立诊所医院急诊部。
我们按照2007年东京指南的急性胆囊炎标准，研究了324例年龄超过15岁且无年龄上限的患者（男性120例，女性204例）（此处原文“a cord to”可能有误，推测为“according to”，译文按推测翻译）。202例患者术前诊断为慢性胆囊炎，89例为急性胆囊炎，所有患者均接受胆囊切除术，并在解剖病理科对手术标本进行研究。急性胆囊炎的解剖病理学标准是存在多形核细胞（PMN），慢性胆囊炎急性加重的标准是存在PMN和单核细胞（MN），慢性胆囊炎的标准是存在MN，伴或不伴有纤维化。
这项研究表明，东京指南诊断标准的敏感性为82.14%，特异性为74.03%，阳性预测值为46%。根据贝叶斯定理，科尔多瓦市的预测值为18.49%。
我们的研究与东京指南在急性胆囊炎的特异性和阳性预测值方面存在重要差异。在我们的研究中，有一重要组慢性胆囊炎急性加重的患者未被纳入东京指南急性胆囊炎诊断标准的分类中。
