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Background: In the year 2007 a group of experts come together to discuss criteria for acute cholecystitis and to establish therapeutic guidelines and states of gravity in this disease. Objectives: we correlated the criteria of the Tokyo Guidelines 2007 with the anatomopathology study of the surgical specimen.Setting: Service of Urgencies of the National Clinic Hospital in Cordoba, Argentine.Methods: We studied 324 patients (120 male and 204 female) older than 15 years and without limits of age with the criteria of acute cholecystitis a cord to the Tokyo guidelines 2007. 202 patients had a preoperative diagnosis of chronic cholecystitis and 89 of acute cholecystitis, all received cholecystectomy and studied the operative specimen in the anatomopathology department. Anatomopathology criteria for acute cholecystitis were the presence of polimorpho nuclear cells (PMN), for acute exacerbation of chronic cholecystitis the presence of PMN and monomorpho nuclear cells (MN), and for chronic cholecystitis the presence of MN with or without fibrosis.Results: This work showed 82,14% of sensitivity for the diagnostic criteria of Tokyo guidelines, 74,03% of specificity, and positive predictive value of 46%. With the Bayes Theorem the predictive value in Cordoba city was 18,49%.Conclusion: There is an important difference in the specificity and positive predictive value between our work and the Tokyo guidelines for acute cholecystitis. There is an important group of patients in our work with acute exacerbation of chronic cholecystitis that is not classified in the diagnostic criteria for acute cholecystitis of Tokyo guidelines. UTILIDAD DE LAS GUIAS DE TOKIO EN LA COLECISTITIS AGUDA. Correlacion Anatomopatologica (Largo) GUIAS DE TOKIO Y COLECISTITIS AGUDA (Corto) RESUMENIntroduccion: En el ano 2007 un grupo de expertos reunidos en Tokio han ideado los criterios para el diagnostico de colecistitis aguda con el objeto de establecer pautas terapeuticas e idear grados de gravedad en esta patologia.Material y Metodo: Se estudiaron 324 pacientes (120 masculinos y 204 femeninos) mayores de 15 anos sin limite de edad con los criterios diagnosticos para colecistitis aguda segun las guias de Tokio 2007. Se diferenciaron 202 pacientes con diagnostico preoperatorio de colecistitis cronica litiasica y 89 con diagnostico de colecistitis aguda, todos sometidos a colecistectomia y a posterior se estudiaron las piezas operatorias en el departamento de anatomia patologica utilizando como criterios de colecistitis aguda la presencia de celulas polimorfo nucleares (PMN), de colecistitis cronica reagudizada la presencia de PMN mas mononucleares (MN), y para colecistitis cronica la presencia de MN con o sin focos de fibrosis.Resultados: El estudio mostro una sensibilidad del 82,14% para los criterios diagnosticos de las guias de Tokio, una especificidad del 74,03% y un valor predictivo positivo del 46%. Aplicando el Teorema de Bayes para analizar el valor predictivo, se obtuvo que el mismo sea del 18,49% en nuestra comunidad.Conclusiones: Existe una notoria diferencia en cuanto a la especificidad y valor predictivo positivo de los criterios de diagnostico de CA establecidos en las guias de Tokio y las obtenidas en nuestro trabajo. Existe un grupo importante de pacientes con diagnostico de enfermedad cronica reagudizada que no es clasificada en los trabajos de Tokio.

Useful of Tokyo Guidelines in the diagnosis of acute cholecystitis. Anatomopathologie correlationship