TY - JOUR
T1 - Background
T2 - Tokyo Guidelines for the management of acute cholangitis and cholecystitis
AU - Takada, Tadahiro
AU - Kawarada, Yoshifumi
AU - Nimura, Yuji
AU - Yoshida, Masahiro
AU - Mayumi, Toshihiko
AU - Sekimoto, Miho
AU - Miura, Fumihiko
AU - Wada, Keita
AU - Hirota, Masahiko
AU - Yamashita, Yuichi
AU - Nagino, Masato
AU - Tsuyuguchi, Toshio
AU - Tanaka, Atsushi
AU - Kimura, Yasutoshi
AU - Yasuda, Hideki
AU - Hirata, Koichi
AU - Pitt, Henry A.
AU - Strasberg, Steven M.
AU - Gadacz, Thomas R.
AU - Bornman, Philippus C.
AU - Gouma, Dirk J.
AU - Belli, Giulio
AU - Liau, Kui Hin
PY - 2007/1
Y1 - 2007/1
N2 - There are no evidence-based-criteria for the diagnosis, severity assessment, of treatment of acute cholecysitis or acute cholangitis. For example, the full complement of symptoms and signs described as Charcot's triad and as Reynolds' pentad are infrequent and as such do not really assist the clinician with planning management strategies. In view of these factors, we launched a project to prepare evidence-based guidelines for the management of acute cholangitis and cholecystitis that will be useful in the clinical setting. This research has been funded by the Japanese Ministry of Health, Labour, and Welfare, in cooperation with the Japanese Society for Abdominal Emergency Medicine, the Japan Biliary Association, and the Japanese Society of Hepato-Biliary-Pancreatic Surgery. A working group, consisting of 46 experts in gastroenterology, surgery, internal medicine, emergency medicine, intensive care, and clinical epidemiology, analyzed and examined the literature on patients with cholangitis and cholecystitis in order to produce evidence-based guidelines. During the investigations we found that there was a lack of high-level evidence, for treatments, and the working group formulated the guidelines by obtaining consensus, based on evidence categorized by level, according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence of May 2001 (version 1). This work required more than 20 meetings to obtain a consensus on each item from the working group. Then four forums were held to permit examination of the Guideline details in Japan, both by an external assessment committee and by the working group participants (version 2). As we knew that the diagnosis and management of acute biliary infection may differ from country to country, we appointed a publication committee and held 12 meetings to prepare draft Guidelines in English (version 3). We then had several discussions on these draft guidelines with leading experts in the field throughout the world, via e-mail, leading to version 4. Finally, an International Consensus Meeting took place in Tokyo, on 1-2 April, 2006, to obtain international agreement on diagnostic criteria, severity assessment, and management.
AB - There are no evidence-based-criteria for the diagnosis, severity assessment, of treatment of acute cholecysitis or acute cholangitis. For example, the full complement of symptoms and signs described as Charcot's triad and as Reynolds' pentad are infrequent and as such do not really assist the clinician with planning management strategies. In view of these factors, we launched a project to prepare evidence-based guidelines for the management of acute cholangitis and cholecystitis that will be useful in the clinical setting. This research has been funded by the Japanese Ministry of Health, Labour, and Welfare, in cooperation with the Japanese Society for Abdominal Emergency Medicine, the Japan Biliary Association, and the Japanese Society of Hepato-Biliary-Pancreatic Surgery. A working group, consisting of 46 experts in gastroenterology, surgery, internal medicine, emergency medicine, intensive care, and clinical epidemiology, analyzed and examined the literature on patients with cholangitis and cholecystitis in order to produce evidence-based guidelines. During the investigations we found that there was a lack of high-level evidence, for treatments, and the working group formulated the guidelines by obtaining consensus, based on evidence categorized by level, according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence of May 2001 (version 1). This work required more than 20 meetings to obtain a consensus on each item from the working group. Then four forums were held to permit examination of the Guideline details in Japan, both by an external assessment committee and by the working group participants (version 2). As we knew that the diagnosis and management of acute biliary infection may differ from country to country, we appointed a publication committee and held 12 meetings to prepare draft Guidelines in English (version 3). We then had several discussions on these draft guidelines with leading experts in the field throughout the world, via e-mail, leading to version 4. Finally, an International Consensus Meeting took place in Tokyo, on 1-2 April, 2006, to obtain international agreement on diagnostic criteria, severity assessment, and management.
KW - Biliary drainage
KW - Charcot's triad
KW - Cholangitis
KW - Cholecystitis
KW - Reynold's pentad
UR - http://www.scopus.com/inward/record.url?scp=33846679618&partnerID=8YFLogxK
U2 - 10.1007/s00534-006-1150-0
DO - 10.1007/s00534-006-1150-0
M3 - Article
C2 - 17252291
AN - SCOPUS:33846679618
SN - 0944-1166
VL - 14
SP - 1
EP - 10
JO - Journal of Hepato-Biliary-Pancreatic Surgery
JF - Journal of Hepato-Biliary-Pancreatic Surgery
IS - 1
ER -