Evidence-based clinical practice guidelines for cholelithiasis 2016

Area of Science:

• Gastroenterology
• Clinical Practice Guidelines

Background:

• Cholelithiasis (gallstones) is a prevalent gastroenterological condition.
• Significant advancements have been made in therapeutic modalities for gallstones and their complications.

Purpose of the Study:

• To present the revised evidence-based clinical practice guidelines for cholelithiasis by the Japanese Society of Gastroenterology.
• To provide clinicians with updated recommendations for the diagnosis and management of cholelithiasis and its complications.

Main Methods:

• Selection of 43 clinical questions across four categories: epidemiology/pathogenesis, diagnosis, treatments, and prognosis/complications.
• Comprehensive literature search of MEDLINE, Cochrane, and Igaku Chuo Zasshi databases (1983-June 2012).
• Development of guidelines using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

Main Results:

• The guidelines detail stepwise diagnosis using imaging modalities.
• Treatment strategies for cholecystolithiasis, choledocholithiasis, and hepatolithiasis are presented with a flowchart.
• Emphasis on flexibility in treatment choices based on clinical environment due to improved endoscopic and surgical techniques.

Conclusions:

• The revised guidelines offer evidence-based, flexible approaches to cholelithiasis management.
• These updated guidelines are suitable for daily clinical practice by healthcare professionals.
• The guidelines reflect the latest improvements in endoscopic and surgical interventions for gallstone disease.