According to the Tokyo 2018 guidelines, the evaluation of patients diagnosed with acute cholecystitis in the emergency department

Objective: Acute cholecystitis is a disease that requires urgent surgery and has a high number of presentations to the emergency department. Early recognition of acute cholecystitis in the emergency department is crucial for reducing mortality and morbidity. Our study aimed to investigate the diagnostic and prognostic efficacy of Tokyo 2018 acute cholecystitis criteria in patients presenting with suspected acute cholecystitis to our emergency department. Materials and Methods: Demographic, radiological, and laboratory characteristics of patients diagnosed with acute cholecystitis according to Tokyo 2018 Acute Cholecystitis criteria, who presented to the Emergency Department of Başkent University Hospital between 01.Jan.2021, and January 1.Jan. 2022, were retrospectively evaluated. The demographic features, presenting complaints, laboratory parameters, phases and imaging modalities used were recorded. The data were analyzed using SPSS v25.0 software package, and p<0.05 was considered statistically significant. Symptoms: In our study, which included 191 patients, the mean age was 61.9 ± 18.4 years, with 63.4% (n=121) being female. The most common presenting complaint was epigastric pain (86.3%). Murphy's sign was positive in 27.2% (n=52) of patients, while fever was present in 9.9% (n=19) of patients. 45.52% of the patients had leukocytosis, with a mean leukocyte count of 10.2 (8.14 – 13.6). Patients were classified according to stages as stage 1: 89% (n=169), stage 2: 7% (n=14), and stage 3: 4% (n=4). High leukocyte count was found in 37% of stage 1 patients, 100% of stage 2 patients, and 87.5% of stage 3 patients. 48.7% (n=93) of the patients had Ultrasonography, 83.2% (n=159) had CT, while 31.9% of the patients had both CT and Ultrasonography. Conclusion: Our study highlights the possibility of rapid and easy diagnosis of acute cholecystitis in patients presenting to the emergency department by using Tokyo criteria. It emphasizes the significance of being familiar with the demographic, clinical, laboratory, and imaging method findings and provides insights into the prognosis of patients using the Tokyo severity index.