title: TG13 management bundles for acute cholangitis and cholecystitis.
abstract: 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.
authors.affiliation: Department of Surgery, Kitakyushu Municipal Yahata Hospital, 4-18-1 Nishihon-machi, Yahatahigashi-ku, Kitakyushu, Fukuoka, 805-8534, Japan. kohji.okamot@gmail.com
authors.forename: Kohji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Steven M
authors.initials: SM
authors.lastname: Strasberg
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Solomkin
authors.forename: Henry A
authors.initials: HA
authors.lastname: Pitt
authors.forename: O James
authors.initials: OJ
authors.lastname: Garden
authors.forename: Markus W
authors.initials: MW
authors.lastname: Büchler
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Miura
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kimura
authors.forename: Ryota
authors.initials: R
authors.lastname: Higuchi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.forename: Harumi
authors.initials: H
authors.lastname: Gomi
authors.forename: Shinya
authors.initials: S
authors.lastname: Kusachi
authors.forename: Seiki
authors.initials: S
authors.lastname: Kiriyama
authors.forename: Masamichi
authors.initials: M
authors.lastname: Yokoe
authors.forename: Wan-Yee
authors.initials: WY
authors.lastname: Lau
authors.forename: Myung-Hwan
authors.initials: MH
authors.lastname: Kim
mesh_terms: D002761:Cholangitis / Q000628:therapy*; D041881:Cholecystitis, Acute / Q000628:therapy*; D002985:Clinical Protocols; D006801:Humans