Department of Surgery, Kitakyushu Municipal Yahata Hospital, 4-18-1 Nishihon-machi, Yahatahigashi-ku, Kitakyushu, Fukuoka, 805-8534, Japan.
J Hepatobiliary Pancreat Sci. 2013 Jan;20(1):55-9. doi: 10.1007/s00534-012-0562-2.
Bundles 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. Free full-text articles and a mobile application of TG13 are available via http://www.jshbps.jp/en/guideline/tg13.html.
近年来，在指南中越来越多地使用了定义临床实践中必须执行的强制性项目或程序的捆绑包。遵守捆绑包可以改善目标疾病的预后以及指南的制定。2007 年的《东京指南》中没有采用捆绑包，但更新的 2013 年《东京指南》（TG13）采用了这一有用的工具。实用指南中准备了在临床实践中强烈推荐的项目或程序，并将其作为管理捆绑包呈现。TG13 为急性胆管炎和急性胆囊炎的管理定义了强制性项目。TG13 捆绑包中的关键部分包括诊断过程、严重程度评估、必要时患者的转移、治疗方法和时间进程。遵守这些捆绑包应该可以改善急性胆管炎和胆囊炎的预后。在使用 TG13 管理捆绑包时，需要进行进一步的临床研究，以评估捆绑包的有效性和结果。预计本报告将有助于构建证据，并有助于进一步更新《东京指南》。可通过 http://www.jshbps.jp/en/guideline/tg13.html 免费获取 TG13 的全文文章和移动应用程序。
