《东京指南(2018)》急性胆道感染诊疗策略更新解读

A review of Tokyo Guidelines 2018 for the management of acute biliary infections

《东京指南(2007)》(TG07)是世界范围内第一个针对急性胆管炎和急性胆囊炎的指南,并于2013年进行了修订。结合2011—2013年日本和中国台湾地区多中心大样本的急性胆道感染流行病学研究结果,2017年日本再次对指南进行了更新修订,发布了《东京指南(2018)》(TG18)。新版指南共分为10个部分,主要涉及指南的形成背景,急性胆管炎和急性胆囊炎的诊断、严重程度分级,抗生素的使用,胆管引流技术的选择,腹腔镜胆囊切除术的安全步骤,诊疗流程等方面。同时,为方便临床使用制定了管理包,并附有配套视频和手机软件客户端。TG18较全面地总结概括了急性胆道感染临床诊治的指导原则和具体的诊疗措施,反映了急性胆管炎和胆囊炎的治疗现状与进展。

The Tokyo Guidelines,published in 2007,is the first worldwide guideline to addressing acute cholangitis and acute cholecystitis and was revised in 2013. In line with the results of the epidemiological study of acute biliary tract infection in Japan-China Taiwan multicenter large sale from 2011 to 2013,the guideline was updated again in 2017 and published Tokyo Guidelines 2018. Tokyo Guidelines 2018 is divided into 10 parts. It covers the background of the guidelines,diagnosis of acute cholangitis and acute cholecystitis,grading of severity,use of antibiotics,choice of biliary drainage technique,laparoscopic cholecystectomy safety steps,treatment processes and so on. At the same time,for the convenience of clinical management,it developed a management bundle supporting with video and mobile software client. The Tokyo Guideline 2018 summarizes the guiding principles of clinical diagnosis and treatment of acute cholangitis more comprehensively,and reflects the current status and progress in the treatment of acute cholangitis and cholecystitis.