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Table 1 Sections/topics, key questions and key words

From: 2020 World Society of Emergency Surgery updated guidelines for the diagnosis and treatment of acute calculus cholecystitis

Section/topic Key questions Key words
1. Diagnosis of Acute Calculus Cholecystitis Which is the most reliable approach for the diagnosis of ACC?
Which initial imaging technique should be used in case of a suspected diagnosis of ACC?
Which is the role of other imaging techniques (e.g. Hepatobiliary iminodiacetic acid—HIDA scan, abdominal computed tomography—CT scan and magnetic resonance) in the diagnosis of ACC?
Acute calculus cholecystitis Diagnosis, Ultrasound, Gallstones disease diagnosis
2. Associated common bile duct stones (CBDS) Are elevated LFTs or bilirubin sufficient for the diagnosis of CBDS in patients with ACC?
Which imaging features are predictive of CBDS in patients with ACC?
Which tests should be performed to assess the risk of CBDS in patients with ACC?
Which is the best tool to stratify the risk for CBDS in patients with ACC?
Which actions are warranted in patients with ACC and at moderate for CBDS?
Which actions are warranted in patients with ACC and at high risk for CBDS?
Which is the appropriate treatment of CBDS in patients with ACC?
Common bile duct stone; choledocholithiasis; endoscopic ultrasound, MRCP, ERCP
3. Surgical treatment of acute calculus cholecystitis Which is the preferred first line of treatment for patients with ACC?
When should laparoscopic cholecystectomy be avoided in patients with ACC?
Is laparoscopic cholecystectomy safe and feasible for patients with ACC who have liver cirrhosis, who are older than 80 years and who are pregnant?
Which surgical strategies should be adopted in case of difficult anatomic identification during cholecystectomy for ACC?
When should conversion from laparoscopic to open cholecystectomy be considered in patients with ACC?
Acute calculus cholecystitis, Surgery, Laparoscopy, Laparotomy, Cholecystectomy, Partial cholecystectomy, Subtotal cholecystectomy, Cirrhosis, Pregnancy
4. Timing of cholecystectomy in people with acute calculus cholecystitis Which is the optimal timing for laparoscopic cholecystectomy in patients with ACC? Acute calculus cholecystitis, acute cholecystitis
5.Risk prediction in patients with acute calculus cholecystitis How can the prognosis and surgical risk be assessed for patients with ACC? Acute calculus cholecystitis, Gallstone disease, Surgical risk score, High risk patient, old patient, PPossum score, Apache score
6. Alternative treatment for patients who are not suitable for surgery: non-operative management and gallbladder drainage techniques When should Non-Operative Management (NOM) be considered for patients with ACC?
Which is the first-choice treatment for ACC in high risk patients?
Which is the role of gallbladder drainage in patients with ACC who are not suitable for surgery?
Should delayed cholecystectomy be offered to patients with ACC after the reduction of perioperative risk?
Can endoscopic gallbladder drainage be considered an alternative to PTGBD in patients with ACC who are not suitable for surgery?
Which is the role of endoscopic transmural ultrasound-guided gallbladder drainage (EUS-GBD) in patients with ACC who are not suitable for surgery?
Gallstones Dissolution, No-surgery gallstones, Extra-corporeal shock wave lithotripsy, Acute calculus cholecystitis, Gallstone disease, Management Gallstones, Endoscopy, Gallstone removal, Observation cholecystitis, Non operative management cholecystitis, Gallbladder drainage Percutaneous gallbladder drainage, Cholecystostomy, High Risk Patient, Stent
7. Antibiotic treatment on acute calculus cholecystitis Which is the optimal antibiotic treatment for patients with uncomplicated ACC?
Which is the optimal antibiotic treatment for patients with complicated ACC?
Which is the role of microbiological cultures and sensitivities in patients with ACC?
Antibiotics, Acute calculus cholecystitis, Gallstone disease, Management Gallstones