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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

Evidence-based clinical practice guidelines for cholelithiasis 2021.

Naotaka Fujita^1,2, Ichiro Yasuda³, Itaru Endo³

¹Guidelines Committee for Creating and Evaluating the "Evidence-Based Clinical Practice Guidelines for Cholelithiasis'', The Japanese Society of Gastroenterology, 6F Shimbashi i-MARK Building, 2-6-2 Shimbashi, Minato-ku, Tokyo, 105-0004, Japan. docfujita@gmail.com.

Journal of Gastroenterology

|July 15, 2023

Summary

Updated clinical practice guidelines for cholelithiasis (gallstones) offer evidence-based recommendations for diagnosis and treatment. These guidelines incorporate the GRADE system and cover epidemiology, pathogenesis, and prognosis for improved patient care.

Keywords:

Cholelithiasis Common bile duct stones Endoscopic treatment Gallbladder stones Intrahepatic stones Surgical treatment

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Last Updated: Jul 23, 2025

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

Published on: September 13, 2022

Area of Science:

Gastroenterology
Clinical Practice Guidelines

Background:

The Japanese Society of Gastroenterology has previously published guidelines for cholelithiasis in 2010 and 2016.
The third edition reflects recent evidence and adheres to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.

Purpose of the Study:

To present the updated English version of the evidence-based clinical practice guidelines for cholelithiasis.
To provide comprehensive guidance on the diagnosis, treatment, and prognosis of gallstone disease.

Main Methods:

Reviewed and rearranged clinical questions into background, clinical, and future research categories.
Conducted literature searches (MEDLINE, Cochrane Library, Igaku Chuo Zasshi) from 1983-2019, supplemented by recent data.
Evaluated evidence levels and determined recommendation strengths using the Delphi method, considering benefits, harms, patient preferences, and cost-benefit.

Main Results:

52 questions (29 BQ, 19 CQ, 4 FRQ) were adopted, covering epidemiology, pathogenesis, diagnosis, treatment, complications, and prognosis.
A comprehensive flowchart for diagnosing and treating gallbladder, common bile duct, and intrahepatic stones was developed.

Conclusions:

The revised guidelines offer contemporary clinical management strategies for cholelithiasis.
These guidelines are expected to aid gastroenterologists and general physicians in clinical decision-making for gallstone patients.