<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2444-054X</journal-id>
<journal-title><![CDATA[Cirugía y cirujanos]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. cir.]]></abbrev-journal-title>
<issn>2444-054X</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Cirugía A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-054X2021000100012</article-id>
<article-id pub-id-type="doi">10.24875/ciru.19001616</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Colecistitis aguda litiásica: aplicación de las Guías de Tokio en los criterios de gravedad]]></article-title>
<article-title xml:lang="en"><![CDATA[Litiasic acute cholecystitis: application of Tokyo Guidelines in severity grading]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Escartín]]></surname>
<given-names><![CDATA[Alfredo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[Marta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Muriel]]></surname>
<given-names><![CDATA[Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cuello]]></surname>
<given-names><![CDATA[Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pinillos]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santamaría]]></surname>
<given-names><![CDATA[Maite]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Salvador]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Olsina]]></surname>
<given-names><![CDATA[Jorge-Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Arnau de Vilanova Institut de Recerca Biomèdica de Lleida Fundació Dr. Pifarré (IRBLleida) Servicio de Cirugía General]]></institution>
<addr-line><![CDATA[Lleida ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2021</year>
</pub-date>
<volume>89</volume>
<numero>1</numero>
<fpage>12</fpage>
<lpage>21</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-054X2021000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-054X2021000100012&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-054X2021000100012&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[ Antecedentes: La colecistitis aguda litiásica (CA) es una de las urgencias quirúrgicas más frecuentes en nuestro medio. La colecistectomía laparoscópica se considera el tratamiento de elección, aunque sigue sin ser una realidad su práctica generalizada.  Objetivo: Analizar la aplicación de las Guías de Tokio en el manejo de la CA y determinar la influencia de la gravedad en el manejo y el pronóstico.  Método: Estudio prospectivo, observacional, de pacientes con diagnóstico primario de CA entre 2010 y 2015. Criterios de exclusión: recidiva de CA, CA como diagnóstico secundario, CA alitiásica u otra patología biliar concomitante. Se ha clasificado la gravedad según las Guías de Tokio de 2013.  Resultados: Se incluyen 998 CA: 338 (33.9%) leves, 567 (56.8%) moderadas y 93 (9.3%) graves. Se operaron 582 pacientes (58.3%), y posteriormente 15 precisaron rescate. Complicaciones posoperatorias Dindo-Clavien &#8805; 12,6%: CA leve 3,6%, CA moderada 12,2%, CA grave 49% (p &lt; 0.001). Mortalidad global 2%: CA leve 0%, CA moderada 0.5%, CA grave 18% (p &lt; 0.001).  Conclusión: La colecistectomía laparoscópica sigue siendo el tratamiento de elección para la CA leve y moderada. En pacientes con CA grave debe valorarse el riesgo-beneficio de la cirugía, dadas las complicaciones y la mortalidad asociadas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Acute calculous cholecystitis (AC) is one of the most frequent surgical emergencies in our field. Laparoscopic cholecystectomy is considered the treatment of choice, although not sufficiently widespread.  Objective: To analyze the application of the Tokyo Guidelines in the management of AC and to determine the influence of the degree of severity on management and prognosis.  Method: Prospective, observational study of patients with a primary diagnosis of AC between 2010 and 2015.  Exclusion criteria: AC recurrence; AC as a secondary diagnosis; acalculous cholecystitis; concurrent biliary pathology. Severity was classified according Tokyo 2013 Guidelines.  Results: 998 patients were included: 338 (33.9%) mild AC, 567 (56.8%) moderate AC, and 93 (9.3%) severe AC. A total of 582 (58.3%) patients were operated on. Postoperative complications Dindo-Clavien grade &#8805; II 12.6%: mild AC 3.6%; moderate AC 12.2%; severe AC 49.0% (p &lt; 0.001). Overall mortality 2%: mild AC 0%; moderate AC 0.5%; severe AC 18.0% (p &lt; 0.001).  Conclusion: Urgent laparoscopic cholecystectomy remains the treatment of choice for mild and moderate AC. In patients with severe AC, the risks and benefits of surgery should be assessed, given the high degree of complications and associated mortality.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Colecistectomía laparoscópica]]></kwd>
<kwd lng="es"><![CDATA[Colecistitis aguda]]></kwd>
<kwd lng="es"><![CDATA[Colecistostomía]]></kwd>
<kwd lng="es"><![CDATA[Guías de Tokio]]></kwd>
<kwd lng="es"><![CDATA[Recidiva]]></kwd>
<kwd lng="en"><![CDATA[Laparoscopic cholecystectomy]]></kwd>
<kwd lng="en"><![CDATA[Acute cholecystitis]]></kwd>
<kwd lng="en"><![CDATA[Cholecystostomy]]></kwd>
<kwd lng="en"><![CDATA[Tokyo guidelines]]></kwd>
<kwd lng="en"><![CDATA[Recurrence]]></kwd>
</kwd-group>
</article-meta>
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