Table 2 TG 18 severity garding for AC

Grade 1—Mild

• Acute cholecystitis not meeting other severity criteria

• Mild gallbladder inflammation, no organ dysfunction

Grade 2—Moderate

Acute cholecystitis with any of the following but no organ/system dysfunction:

• Elevated white blood cell count (> 18,000/mL)

• Palpable tender mass at right upper quadrant

• Duration of complaints exceeding 72 h

• Marked local inflammation (such as biliary peritonitis, pericholecystic abscess, hepatic abscess, gangrenous cholecystitis, emphysematous cholecystitis)

Grade 3—Severe

Acute cholecystitis with dysfunction of any one of the following organs/systems:

• Cardiovascular dysfunction (hypotension requiring treatment with dopamine > 5 mg/kg/min of body weight or any dose of norepinephrine)

• Neurological dysfunction (decreased levels of consciousness)

• Respiratory dysfunction (ratio of PaO2/FiO2 < 300)

• Renal dysfunction (oliguria, creatine > 2.0 mg/dL)

• Hepatic dysfunction (PT-INR > 1.5)