Department of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
Department of Surgery, Center for Gastroenterology and Liver Disease, Kitakyushu City Yahata Hospital, Fukuoka, Japan.
J Hepatobiliary Pancreat Sci. 2018 Jan;25(1):96-100. doi: 10.1002/jhbp.519. Epub 2017 Dec 16.
Management bundles that define items or procedures strongly recommended in clinical practice have been used in many guidelines in recent years. Application of these bundles facilitates the adaptation of guidelines and helps improve the prognosis of target diseases. In Tokyo Guidelines 2013 (TG13), we proposed management bundles for acute cholangitis and cholecystitis. Here, in Tokyo Guidelines 2018 (TG18), we redefine the management bundles for acute cholangitis and cholecystitis. Critical parts of the bundles in TG18 include the diagnostic process, severity assessment, transfer of patients if necessary, and therapeutic approach at each time point. Observance of these items and procedures should improve the prognosis of acute cholangitis and cholecystitis. Studies are now needed to evaluate the dissemination of these TG18 bundles and their effectiveness. Free full articles and mobile app of TG18 are available at: http://www.jshbps.jp/modules/en/index.php?content_id=47. Related clinical questions and references are also included.
近年来，许多指南都采用了定义临床实践中强烈推荐的项目或程序的管理束。这些管理束的应用有助于指南的适应，并有助于改善目标疾病的预后。在 2013 年东京指南（TG13）中，我们提出了急性胆管炎和胆囊炎的管理束。在这里，在 2018 年东京指南（TG18）中，我们重新定义了急性胆管炎和胆囊炎的管理束。TG18 管理束的关键部分包括诊断过程、严重程度评估、必要时的患者转移以及每个时间点的治疗方法。遵守这些项目和程序应该可以改善急性胆管炎和胆囊炎的预后。现在需要进行研究来评估这些 TG18 管理束的传播及其有效性。可在以下网址获取 TG18 的全文文章和移动应用程序：http://www.jshbps.jp/modules/en/index.php?content_id=47。还包括相关的临床问题和参考文献。
