Table 1 TG18/TG13 severity grading for acute cholecystitis [8]

Grade III (Severe)

Associated with dysfunction of any of the following organs/ systems:

1. Cardiovascular dysfunction (hypotension requiring treatment with dopamine 5 µg/kg per min or any dose of norepinephrine)

2. Neurological dysfunction (decreased level of consciousness)

3. Respiratory dysfunction (Pa02/Fi02 ratio 300)

4. Renal dysfunction (oliguria, creatinine 2.0 mg/dl)

5. Hepatic dysfunction (PT-INR 1.5)

6. Hematological dysfunction (platelet count 100,000/mm³)

Grade II

(Moderate)

Associated with any one of the following conditions:

1. Elevated white blood cell count (18,000/mm³)

2. Palpable tender mass in the right upper abdominal quadrant

3. Duration of complaints 72 h

4. Marked local inflammation (gangrenous cholecystitis, pericholecystic abscess, hepatic abscess, biliary peritonitis, emphysematous cholecystitis)

Grade I

(Mild)

Does not meet the criteria of grade II or grade III acute cholecystitis

Can also be defined as acute cholecystitis in a healthy patient with no organ dysfunction and mild inflammatory changes in the GB