Classification Schemes for Acute Cholecystitis

In this review article, we will evaluate and describe the current major grading systems for acute cholecystitis to help the reader better understand the history, strengths, and weaknesses of these scales. Tokyo Guidelines (TG) for Acute Cholecystitis and CholangitisAll the major grading scale systems attempt to classify cholecystitis based on the ability to categorize the grades of inflammation.The TG were the initial attempts to help both diagnose and quantify the severity of cholecystitis, as the definitions up until then had been somewhat ambiguous.Subsequent scales have focused more on the delineation of an assigned grade by the severity of the disease, as opposed to diagnosis and severity assessment.The TG for acute cholangitis and cholecystitis were initially published in 2007.Specifically for acute cholecystitis, the guidelines assigned three categories of severity derived from the diagnostic criteria that included mild, moderate, or severe.Both the diagnostic criteria and the grading scale were based on a systematic review