2016 WSES guidelines on acute calculous cholecystitis

Area of Science:

• Gastroenterology and Hepatobiliary Surgery
• Surgical Guidelines Development
• Emergency Surgery Protocols

Background:

• Acute calculus cholecystitis presents management ambiguities.
• Existing clinical practices lack standardized protocols.
• The World Society of Emergency Surgery identified critical knowledge gaps.

Purpose of the Study:

• To establish comprehensive guidelines for acute calculus cholecystitis.
• To clarify diagnostic criteria and treatment strategies.
• To provide an evidence-based algorithm for patient management.

Main Methods:

• Systematic review of existing literature.
• Consensus development by the World Society of Emergency Surgery.
• Formulation of diagnostic and therapeutic algorithms.

Main Results:

• Guidelines cover diagnosis, antimicrobial therapy, and common bile duct stone evaluation.
• Identification of high-risk patients is crucial for treatment decisions.
• Laparoscopic cholecystectomy is the preferred surgical approach for most patients.

Conclusions:

• The proposed algorithm prioritizes laparoscopic cholecystectomy post-diagnosis and risk assessment.
• Guidelines serve as a decision-support tool, not a replacement for clinical judgment.
• Management should be individualized, especially for high-risk patients.