Japanese Clinical Guidelines for Endoscopic Treatment of Pancreatolithiasis.
OBJECTIVE
In addition to surgery, procedures for patients with pancreatolithiasis are developing; therefore, establishing practical guidelines for the management of pancreatolithiasis is required.


METHODS
Three committees (the professional committee for asking clinical questions (CQs) and statements by Japanese endoscopists, the expert panel committee for rating statements by the modified Delphi method, and the evaluating committee by moderators) were organized. Eight endoscopists and a surgeon for pancreatolithiasis made the CQs and statements from a total of 694 reports of published literature by PubMed search (from 1983 to 2012). The expert panelists individually rated these clinical statements using a modified Delphi approach, in which a clinical statement receiving a median score greater than 7 on a 9-point scale from the panel was regarded as valid.


RESULTS
The professional committee made 3, 7, and 10 CQs and statements for the concept and pathogenesis, diagnosis, and treatment, respectively. The expert panelists regarded them as valid after a 2-round modified Delphi approach.


CONCLUSIONS
After evaluation by the moderators, the Japanese clinical guidelines for pancreatolithiasis were established. Further discussions and studies for international guidelines are needed.
From the *Department of Gastroenterology, Second Teaching Hospital, Fujita Health University, Nagoya, †Division of Gastroenterology and Hepatology, Toho University Omori Medical Center, Tokyo, ‡Department of Internal Medicine, Aizu Medical Center, Fukushima Medical University, Fukushima, §Department of Community-based Medical Education, Nagoya City University Graduate School of Medical Sciences, Nagoya, ∥Department of General Medicine, Hiroshima University Graduate School of Medical Science, Programs of Applied Medicine, Clinical Pharmacotherapy, Hiroshima, ¶Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, #Department of Gastroenterology, Sendai City Medical Center, Sendai, *Division of Biliopancreatology, Sapporo Kosei General Hospital, Sapporo, ††Department of Surgery, Jichi Medical University, Shimotsuke, ‡‡Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, §§Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, ∥∥Department of Gastroenterology, Tokyo Women's Medical University, Tokyo, ¶¶Department of Surgery, Kyorin University School of Medicine, Mitaka, and ##Department of Surgery, Kinki University School of Medicine, Osakasayama, Japan.
Kazuo
K
Inui
Yoshinori
Y
Igarashi
Atsushi
A
Irisawa
Hirotaka
H
Ohara
Susumu
S
Tazuma
Yoshiki
Y
Hirooka
Naotaka
N
Fujita
Hiroyuki
H
Miyakawa
Naohiro
N
Sata
Tooru
T
Shimosegawa
Masao
M
Tanaka
Keiko
K
Shiratori
Masanori
M
Sugiyama
Yoshifumi
Y
Takeyama
D003697:Delphi Technique; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D007564:Japan; D020347:Lithiasis / Q000175:diagnosis / Q000628:therapy*; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000628:therapy*; D017410:Practice Guidelines as Topic