TG13 management bundles for acute cholangitis and cholecystitis

Journal of Hepato-Biliary-Pancreatic Sciences - 2013
Kohji Okamoto1, Tadahiro Takada2, Steven M. Strasberg3, Joseph S. Solomkin4, Henry A. Pitt5, O. James Garden6, Markus W. Büchler7, Masahiro Yoshida8, Fumihiko Miura2, Yasutoshi Kimura9, Ryota Higuchi10, Yuichi Yamashita11, Toshihiko Mayumi12, Harumi Gomi13, Shozo Kusachi14, Seiki Kiriyama15, Masamichi Yokoe16, Wan Yee Lau17, Myung Hwan Kim18
1Department of Surgery; Kitakyushu Municipal Yahata Hospital; 4-18-1 Nishihon-machi, Yahatahigashi-ku Kitakyushu Fukuoka 805-8534 Japan
2Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
3Section of Hepatobiliary and Pancreatic Surgery Washington University in Saint Louis School of Medicine Saint Louis MO USA
4Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
5Department of Surgery, Indiana University School of Medicine, Indianapolis IN USA
6Clinical Surgery, The University of Edinburgh, Edinburgh, UK
7Department of Surgery, University of Heidelberg, Heidelberg, Germany
8Clinical Research Center Kaken Hospital, International University of Health and Welfare, Ichikawa, Japan
9Department of Surgical Oncology and Gastroenterological Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
10Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan
11Department of Gastroenterological Surgery, Fukuoka University School of Medicine, Fukuoka, Japan
12Department of Emergency and Critical Care Medicine, Ichinomiya Municipal Hospital, Ichinomiya, Japan
13Center for Clinical Infectious Diseases; Jichi Medical University; Tochigi Japan
14Department of Surgery, Toho University Medical Center Ohashi Hospital, Tokyo, Japan
15Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
16General Internal Medicine, Nagoya Daini Red Cross Hospital, Nagoya, Japan
17Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong
18Department of Internal Medicine, Asan Medical Center, University of Ulsan, Seoul, Korea

Tóm tắt

AbstractBundles that define mandatory items or procedures to be performed in clinical practice have been increasingly used in guidelines in recent years. Observance of bundles enables improvement of the prognosis of target diseases as well as guideline preparation. There were no bundles adopted in the Tokyo Guidelines 2007, but the updated Tokyo Guidelines 2013 (TG13) have adopted this useful tool. Items or procedures strongly recommended in clinical practice have been prepared in the practical guidelines and presented as management bundles. TG13 defined the mandatory items for the management of acute cholangitis and acute cholecystitis. Critical parts of the bundles in TG13 include diagnostic process, severity assessment, transfer of patients if necessary, therapeutic approach, and time course. Their observance should improve the prognosis of acute cholangitis and cholecystitis. When utilizing TG13 management bundles, further clinical research needs to be conducted to evaluate the effectiveness and outcomes of the bundles. It is also expected that the present report will lead to evidence construction and contribute to further updating of the Tokyo Guidelines.

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Journal of Hepato-Biliary-Pancreatic Sciences

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