中国慢性胆囊炎、胆囊结石内科诊疗共识意见(2018年)

何相宜; 施健

doi:10.3969/j.issn.1001-5256.2019.06.011

中国慢性胆囊炎、胆囊结石内科诊疗共识意见(2018年)

DOI: 10.3969/j.issn.1001-5256.2019.06.011

何相宜,
施健

中华消化杂志编辑委员会
中华医学会消化病学分会肝胆疾病协作组
上海交通大学医学院附属瑞金医院消化内科
上海长征医院消化内科

详细信息

中图分类号: R575.6
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出版历程
- 收稿日期: 2019-05-30
- 出版日期: 2019-06-20

Consensus on diagnosis and treatment of chronic cholecystitis and gallstones in China (2018)

摘要

摘要: 2014年,我国首次发布了《中国慢性胆囊炎、胆囊结石内科诊疗共识意见(2014年)》,有效规范了国内慢性胆囊炎、胆囊结石的内科诊疗。时隔4年,国内相关临床资料有了新的积累,因此再次组织多学科专家组成专家委员会,多次共同讨论制订了新版共识意见。在新版共识意见中,参考了新制订的中国临床指南的评价标准,并注重加入了中国人自己的研究证据,使其能更好地指导中国人群慢性胆囊炎、胆囊结石的内科诊疗。
- 胆囊炎 /
- 胆囊结石病 /
- 中国 /
- 共识
Abstract: Chinese consensus on the medical diagnosis and treatment of chronic cholecystitis and gallstones (2014) was issued for the first time in 2014 and effectively standardized the medical diagnosis and treatment of chronic cholecystitis and gallstones in China. Five years later, with the accumulation of new clinical data, the experts with various disciplines were invited to establish an expert committee and discuss the new version of the consensus. With reference to the newly developed evaluation criteria in Chinese clinical guidelines, the new version added the research data of the Chinese population, so as to provide guidance for the medical diagnosis and treatment of chronic cholecystitis and gallstones in the Chinese population.
- cholecystitis /
- cholecystolithiasis /
- China /
- consensus

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参考文献(56)

[1]Editorial Board of Chinese Journal of Digestion.Chinese consensus on the medical diagnosis and treatment of Chronic cholecystitis and gallstones (2014, Shanghai) [J].J Clin Hepatol, 2015, 31 (1) :7-11. (in Chinese) 中华消化杂志编辑委员会.中国慢性胆囊炎、胆囊结石内科诊疗共识意见 (2014年) [J].临床肝胆病杂志, 2015, 31 (1) :7-11.

[2] European Association for the Study of the Liver (EASL) .EASLclinical practice guidelines on the prevention, diagnosis and treatment of gallstones[J].J Hepatol, 2016, 65 (1) :146-181.

[3]TAZUMA S, UNNO M, IGARASHI Y, et al.Evidence-based clinical practice guidelines for cholelithiasis 2016[J].J Gastroenterol, 2017, 52 (3) :276-300.

[4]JIANG ZM, ZHAN SY, JIA XW, et al.Basic measures and procedures for the development and revision of Clinical Practice Guidelines[J].Natl Med J China, 2016, 96 (4) :250-253. (in Chinese) 蒋朱明, 詹思延, 贾晓巍, 等.制订/修订《临床诊疗指南》的基本方法及程序[J].中华医学杂志, 2016, 96 (4) :250-253.

[5]QASEEM A, SNOW V, OWENS DK, et al.The development of clinical practice guidelines and guidance statements of the A-merican College of Physicians:Summary of methods[J].Ann Intern Med, 2010, 153 (3) :194-199.

[6] WANG JY, WANG Q, WANG XQ, et al.Development and preliminary validation of the evaluation system for clinical practice guidelines in China[J].Natl Med J China, 2018, 98 (20) :1544-1548. (in Chinese) 王吉耀, 王强, 王小钦, 等.中国临床实践指南评价体系的制定与初步验证[J].中华医学杂志, 2018, 98 (20) :1544-1548.

[7]SUN XM, XU P, MA ZH, et al.An epidemiological survey of benign gallbladder disease in Songjiang District of Shanghai, China[J].World Chin J Dig, 2011, 19 (27) :2881-2885. (in Chinese) 孙晓敏, 徐萍, 马志红, 等.上海松江地区胆囊良性疾病的流行病学调查30901例[J].世界华人消化杂志, 2011, 19 (27) :2881-2885.

[8]ZHU Y, WU ZY, MA XM, et al.An epidemiological investigation of cholelithiasis in employees of Kailuan Corporation in Tangshan of Hebei Province, China[J].J Clin Hepatol, , 2015, 31 (10) :1621-1624. (in Chinese) 朱颖, 吴治宇, 马向明, 等.开滦集团职工胆囊结石临床流行病学调查[J].临床肝胆病杂志, 2015, 31 (10) :1621-1624.

[9]ZENG Q, HE Y, QIANG DC, et al.Prevalence and epidemiological pattern of gallstones in urban residents in China[J].Eur J Gastroenterol Hepatol, 2012, 24 (12) :1459-1460

[10]A BLT, MA J, HE XH, et al.An epidemiological investigation of risk factors for gallstones in Baijiantan and Wuerhe districts in Karamay, China[J].Chin J Hepatobiliary Surg, 2006, 12 (11) :772-774. (in Chinese) 阿不来提, 马骏, 何秀华, 等.克拉玛依市白碱滩及乌尔禾两区胆囊结石的危险因素流行病学调查分析[J].中华肝胆外科杂志, 2006, 12 (11) :772-774.

[11]SHI J, LIU S, XIE WF.Risk factors of cholelithiasis in China:AMeta-analysis[J].Chin J Gastroenterol, 2005, 10 (4) :217-222. (in Chinese) 施健, 刘苏, 谢渭芬.我国胆石症发病危险因素的Meta分析[J].胃肠病学, 2005, 10 (4) :217-222.

[12]RAKESH BH, RAJENDRA GC.A prospective clinicopathological study of 50 cases of chronic calculous cholecystitis in the local population[J].J Evol Med Dent Sci, 2013, 2 (35) :6076-6716.

[13]DOMEYER PJ, SERGENTANIS TN, ZAGOURI F, et al.Chronic cholecystitis in elderly patients.Correlation of the severity of inflammation with the number and size of the stones[J].In Vivo, 2008, 22 (2) :269-272.

[14]KIMURA Y, TAKADA T, KAWARADA Y, et al.Definitions, pathophysiology, and epidemiology of acute cholangitis and cholecystitis:Tokyo Guidelines[J].J Hepatobiliary Pancreat Surg, 2007, 14 (1) :15-26.

[15]YAN WB, XU XF, ZHOU LF.Comparison analysis of 188 cases of acute and chronic cholecystitis bacterial culture and antibiotics sensitivity[J].Modern Diagn Treat, 2013, 24 (17) :3857-3858. (in Chinese) 颜伟笔, 徐小丰, 周龙飞.急、慢性胆囊炎胆汁细菌培养及抗生素敏感性188例比较分析[J].现代诊断与治疗, 2013, 24 (17) :3857-3858.

[16]MERG AR, KALINOWSKI SE, HINKHOUSE MM, et al.Mechanisms of impaired gallbladder contractile response in chronic acalculous cholecystitis[J].J Gastrointest Surg, 2002, 6 (3) :432-437.

[17]LAWRENCE-BROWN MM, CHAKERA TM, HARTLEY DE, et al.Angiographic findings in normal and diseased gallbladders including ischaemic cholecystitis and infarction of the gallbladder[J].Aust N Z J Surg, 1982, 52 (5) :472-477.

[18]BEHAR J, MAWE GM, CAREY MC.Roles of cholesterol and bile salts in the pathogenesis of gallbladder hypomotility and inflammation:Cholecystitis is not caused by cystic duct obstruction[J].Neurogastroenterol Motil, 2013, 25 (4) :283-290.

[19]ATTILI AF, DE SANTIS A, CAPRI R, et al.The natural history of gallstones:The GREPCO experience.The GREPCO Group[J].Hepatology, 1995, 21 (3) :655-660.

[20]FRIEDMAN GD, RAVIOLA CA, FIREMAN B.Prognosis of gallstones with mild or no symptoms:25 years of follow-up in a health maintenance organization[J].J Clin Epidemiol, 1989, 42 (2) :127-136.

[21]AHMED M, DIGGORY R.The correlation between ultrasonography and histology in the search for gallstones[J].Ann RColl Surg Engl, 2011, 93 (1) :81-83.

[22]SHEA JA, BERLIN JA, ESCARCE JJ, et al.Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease[J].Arch Intern Med, 1994, 154 (22) :2573-2581.

[23]THORBLL J, VILMANN P, JACOBSEN B, et al.Endoscopic ultrasonography in detection of cholelithiasis in patients with biliary pain and negative transabdominal ultrasonography[J].Scand J Gastroenterol, 2004, 39 (3) :267-269.

[24]MARZIO L, INNOCENTI P, GENOVESI N, et al.Role of oral cholecystography, real-time ultrasound, and CT in evaluation of gallstones and gallbladder function[J].Gastrointest Radiol, 1992, 17 (3) :257-261.

[25]LI H, HE D, LAO Q, et al.Clinical value of spectral CT in diagnosis of negative gallstones and common bile duct stones[J].Abdom Imaging, 2015, 40 (6) :1587-1594.

[26]CHEN AL, LIU AL, WANG S, et al.Detection of gallbladder stones by dual-energy spectral computed tomography imaging[J].World J Gastroenterol, 2015, 21 (34) :9993-9998.

[27]KAURA SH, HAGHIGHI M, MATZA BW, et al.Comparison of CT and MRI findings in the differentiation of acute from chronic cholecystitis[J].Clin Imaging, 2013, 37 (4) :687-691.

[28]WANG A, SHANBHOGUE AK, DUNST D, et al.Utility of diffusion-weighted MRI for differentiating acute from chronic cholecystitis[J].J Magn Reson Imaging, 2016, 44 (1) :89-97.

[29]MIDDLETON GW, WILLIAMS JH.Diagnostic accuracy of 99Tcm-HIDA with cholecystokinin and gallbladder ejection fraction in acalculous gallbladder disease[J].Nucl Med Commun, 2001, 22 (6) :657-661.

[30]GOUSSOUS N, MAQSOOD H, SPIEGLER E, et al.HIDA scan for functional gallbladder disorder:Ensure that you know how the scan was done[J].Hepatobiliary Pancreat Dis Int, 2017, 16 (2) :197-201.

[31]JONES MW, FERGUSON T.Gallbladder, cholecystitis, chronic[DB/OL].Treasure Island (FL) :Stat Pearls Publishing, 2018 (2018-10-27) [2018-12-13].http://www.ncbi.nlm.nih.gov/books/NBK4702361.

[32]MAY GR, SUTHERLAND LR, SHAFFER EA.Efficacy of bile acid therapy for gallstone dissolution:A meta-analysis of randomized trials[J].Aliment Pharmacol Ther, 2010, 7 (2) :139-148.

[33]YU DD, ANDRALI SS, LI H, et al.Novel FXR (farnesoid X receptor) modulators:Potential therapies for cholesterol gallstone disease[J].Bioorg Med Chem, 2016, 24 (18) :3986-3993.

[34]ZOU DW, XU GM, SU D, et al.The effect of compound azintamide on abdominal fullness in patients with functional dyspepsia, chronic cholecystitis or liver cirrhosis[J].Chin J Dig, 2005, 25 (7) :421-424. (in Chinese) 邹多武, 许国铭, 苏墩, 等.复方阿嗪米特治疗功能性消化不良、慢性胆囊炎、胆结石、肝硬化腹胀的疗效观察[J].中华消化杂志, 2005, 25 (7) :421-424.

[35]CHRISTEN MO.Pinaverium Bromide:A Calcium antagonist with selectivity for the gastrointestinal tract[J].Today’s Therapeutic Trends, 1995, 13 (2) :47-62.

[36]LI C, QIAN W, HOU X.Effect of four medications associated with gastrointestinal motility on Oddi sphincter in the rabbit[J].Pancreatology, 2009, 9 (5) :615-620.

[37]PORTINCASA P, DI CIAULA A, WANG HH, et al.Medicinal treatments of cholesterol gallstones:Old, current and new perspectives[J].Curr Med Chem, 2009, 16 (12) :1531-1542.

[38]THORNELL E, JANSSON R, SVANVIK J.Indomethacin intravenously-a new way for effective relief of biliary pain:a doubleblind study in man[J].Surgery, 1981, 90 (3) :468-472.

[39]THORNELL E, NILSSON B, JANSSON R, et al.Effect of shortterm indomethacin treatment on the clinical course of acute obstructive cholecystitis[J].Eur J Surg, 1991, 157 (2) :127-130.

[40]COLLI A, CONTE D, VALLE SD, et al.Meta-analysis:Nonsteroidal anti-inflammatory drugs in biliary colic[J].Aliment Pharmacol Ther, 2012, 35 (12) :1370-1378.

[41]FRAQUELLI M, CASAZZA G, CONTE D, et al.Non-steroid anti-inflammatory drugs for biliary colic[J].Cochrane Database Syst Rev, 2016, 9:CD006390.

[42]AKRIVIADIS EA, HATZIGAVRIEL M, KAPNIAS D, et al.Treatment of biliary colic with diclofenac:A randomized, doubleblind, placebo-controlled study[J].Gastroenterology, 1997, 113 (1) :225-231.

[43]KUMAR A, DEED JS, BHASIN B, et al.Comparison of the effect of diclofenac with hyoscine-N-butylbromide in the symptomatic treatment of acute biliary colic[J].ANZ J Surg, 2004, 74 (7) :573-576.

[44]YOSHIDA M, TAKADA T, KAWARADA Y, et al.Antimicrobial therapy for acute cholecystitis:Tokyo Guidelines[J].J Hepatobiliary Pancreat Surg, 2007, 14 (1) :83-90.

[45] BILIARY Surgery Group, Surgery Branch of Chinese Medical Association.Diagnosis and treatment guidelines for acute biliary infection (2011 edition) [J].Chin J Dig Surg, 2011, 10 (1) :9-13. (in Chinese) 中华医学会外科学分会胆道外科学组.急性胆道系统感染的诊断和治疗指南 (2011版) [J].中华消化外科杂志, 2011, 10 (1) :9-13.

[46]GURUSAMY KS, SAMRAJ K.Cholecystectomy versus no cholecystectomy in patients with silent gallstones[J].Cochrane Database Syst Rev, 2007, 1:CD006230.

[47]BELLOWS CF, BERGER DH, CRASS RA.Management of gallstones[J].Am Fam Physician, 2005, 72 (4) :637-642.

[48] Biliary Surgery Group, Surgery Branch of Chinese Medical Association.Consensus on the management of benign gallbladder diseases (2011 edition) [J].Chin J Dig Surg, 2011, 10 (1) :14-19. (in Chinese) 中华医学会外科学分会胆道外科学组.胆囊良性疾病治疗决策的专家共识 (2011版) [J].中华消化外科杂志, 2011, 10 (1) :14-19.

[49]CHEN CY, LU CL, CHANG FY, et al.Risk factors for gallbladder polyps in the Chinese population[J].Am J Gastroenterol, 1997, 92 (11) :2066-2068.

[50]OKAMOTO M, OKAMOTO H, KITAHARA F, et al.Ultrasonographic evidence of association of polyps and stones with gallbladder cancer[J].Am J Gastroenterol, 1999, 94 (2) :446-450.

[51]MYERS RP, SHAFFER EA, BECK PL.Gallbladder polyps:Epidemiology, natural history and management[J].Can J Gastroenterol, 2002, 16 (3) :187-194.

[52]WILES R, THOENI RF, BARBU ST, et al.Management and fol ow-up of gallbladder polyps:Joint guidelines between the European Society of Gastrointestinal and Abdominal Radiology (ES-GAR) , European Association for Endoscopic Surgery and other Interventional Techniques (EAES) , International Society of Digestive Surgery-European Federation (EFISDS) and European Society of Gastrointestinal Endoscopy (ESGE) [J].Eur Radiol, 2017, 27 (9) :3856-3866.

[53]ZHANG ZG, GENG XP.An interpretation of the guidelines for the management of acute pancreatitis on the basis of evidence-based medicine by International Association of Pancreatology/American Pancreas Association in 2013 (Ⅲ) [J].J Hepatobiliary Surg, 2014, 22 (1) :62-65. (in Chinese) 张志功, 耿小平.2013年国际胰腺协会/美国胰腺协会循证医学基础上的急性胰腺炎处理指南解读 (三) [J].肝胆外科杂志, 2014, 22 (1) :62-65.

[54]van BAAL MC, BESSELINK MG, BAKKER OJ, et al.Timing of cholecystectomy after mild biliary pancreatitis:A systematic review[J].Ann Surg, 2012, 255 (5) :860-866.

[55]HE JJ, XU KQ, TANG JH.Intestinal obstruction caused by gallstone:Report of 5 cases and review of the literature[J].Chin J Gastrointestinal Surg, 2010, 13 (10) :751-754. (in Chinese) 何建军, 许克勤, 汤建华.胆石性肠梗阻五例报告并文献复习[J].中华胃肠外科杂志, 2010, 13 (10) :751-754.

[56]Branch of Gastrointestinal Diseases, China Association of Chinese Medicine.Expert consensus on the TCM diagnosis and treatment of cholecystitis (2017) [J].Chin J Integr Trad West Med Dig, 2017, 25 (4) :241-246. (in Chinese) 中华中医药学会脾胃病分会.胆囊炎中医诊疗专家共识意见 (2017) [J].中国中西医结合消化杂志, 2017, 25 (4) :241-246.

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