【医脉通-指南】2012+JSGE临床实践指南：胰胆管合流异常.pdfVIP

J Gastroenterol (2012) 47:731–759 DOI 10.1007/s00535-012-0611-2 REVIEW Japanese clinical practice guidelines for pancreaticobiliary maljunction Terumi Kamisawa ? Hisami Ando ? Masafumi Suyama ? Mitsuo Shimada ? Yuji Morine ? Hiroshi Shimada ? Working Committee of Clinical Practice Guidelines for Pancreaticobiliary Maljunction Received: 2 May 2012 / Accepted: 2 May 2012 / Published online: 22 June 2012 ó Springer 2012 Abstract There have been no clinical guidelines for the were prepared by the guidelines committee members and management of pancreaticobiliary maljunction (PBM). The collaborating partners. The CQs were completed after Japanese Study Group on Pancreaticobiliary Maljunction review by members of the editorial committee, meetings of (JSPBM) has proposed to establish clinical practice guide- this committee, public comments on the homepages of the lines on how to deal with PBM, with the support of the JSPBM and the JBA, public hearings, and assessment and Japan Biliary Association (JBA). Because the body of evi- approval by the guidelines evaluation board. PBM includes dence-based literature is relatively small, we decided to cases where the bile duct is dilated (PBM with biliary create guidelines based on the consensus of experts, using dilatation) and those in which it is not (PBM without biliary the medical literature for reference. A total of 46 clinical dilatation). In these guidelines, PBM with biliary dilatation questions (CQs) were considered by the members of the is de?ned as being identical to congenital biliary dilatation editorial committee responsible for the guidelines. The CQs of Todani type I (except for type Ib) and type IV-A, both of covered distinct aspects of PBM: (1) Concepts and Patho- which are accompanied by PBM in almost all cases. These physiology (10 CQs); (2) Diagnosis (10 CQs); (3) Pancre- guidelines are created to provide assistance in the clinical atobiliary complications (9 CQs); and (4) Treatments and practice