medical decision support medical decision support
Sign In

Scoring System of Misawa et al for Severity of Inflammation in Calot's Triangle in a Patient with Cholecystitis

Purpose: To evaluate Calot's triangle in a patient undergoing a laparoscopic cholecystectomy using the grading system of Misawa et al.

Description

Misawa et al used a scoring system to describe inflammation in Calot's triangle, which impacts the outcome of laparoscopic cholecystectomy. This is a modification of the scheme proposed by Chang. The authors are from Jikei University in Tokyo, Japan.


Calot's triangle is defined as:

(1) superior: cystic artery

(2) medial: hepatic duct

(3) inferior: cystic duct

 

Inflammation

Identification of Structures in Calot's Triangle

Grade

Score

none

very easy

I

0

mild

very easy

II

1

moderate

easy to identify and separate

III

2

severe

identifiable but difficult to separate

IV

3

severe

difficult to identify and to separate

V

4

 

A person with Grade V (score 4) findings usually requires conversion to open surgery since the risk of bile duct damage is high during laparoscopic surgery.


To read more or access our algorithms and calculators, please log in or register.

Specialty

Objective

ICD-10