title: Evidence-based clinical practice guidelines for cholelithiasis 2016.
abstract: Cholelithiasis is one of the commonest diseases in gastroenterology. Remarkable improvements in therapeutic modalities for cholelithiasis and its complications are evident. The Japanese Society of Gastroenterology has revised the evidence-based clinical practice guidelines for cholelithiasis. Forty-three clinical questions, for four categories-epidemiology and pathogenesis, diagnosis, treatments, and prognosis and complications-were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This article preferentially describes the clinical management of cholelithiasis and its complications. Following description of the diagnosis performed stepwise through imaging modalities, treatments of cholecystolithiasis, choledocholithiasis, and hepatolithiasis are introduced along with a flowchart. Since there have been remarkable improvements in endoscopic treatments and surgical techniques, the guidelines ensure flexibility in choices according to the actual clinical environment. The revised clinical practice guidelines are appropriate for use by clinicians in their daily practice.
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan. stazuma@hiroshima-u.ac.jp.|Department of General Internal Medicine, Hiroshima University Hospital, Graduate School of Medicine, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan. stazuma@hiroshima-u.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Tazuma
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Unno
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Igarashi
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Inui
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kai
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Maguchi
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Mori
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Shomei
authors.initials: S
authors.lastname: Ryozawa
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nimura
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Fujita
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kubota
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Shoda
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Tabata
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mine
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: , Guidelines Committee for the Japanese Society of Gastroenterology ''Evidence-based clinical practice guidelines for cholelithiasis'', Hiroshima, Japan.
authors.forename: Tooru
authors.initials: T
authors.lastname: Shimosegawa
mesh_terms: D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods; D042883:Choledocholithiasis / Q000601:surgery; D002769:Cholelithiasis / Q000175:diagnosis / Q000628:therapy*; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D008096:Lithotripsy / Q000379:methods; D057792:Mirizzi Syndrome / Q000601:surgery; D016717:Sphincterotomy, Endoscopic / Q000379:methods; D015607:Stents; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D014580:Ursodeoxycholic Acid
keywords: Bile acid dissolution therapy; Cholelithiasis; Endoscopic sphincterotomy; Extracorporeal shock wave lithotripsy; Laparoscopic cholecystectomy