Clinical practice guidelines for IgG4-related sclerosing cholangitis
Clinical practice guidelines for IgG4-related sclerosing cholangitis
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DOI：
10.1002/jhbp.596
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发表时间：
2019-01-01
影响因子：
3
通讯作者：
Yoshida, Masahiro
中科院分区：
文献类型：
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作者：
Kamisawa, Terumi;Nakazawa, Takahiro;Yoshida, Masahiro
IgG4相关硬化性胆管炎(IgG4-SC)是一种独特的胆管炎类型，常与自身免疫性胰腺炎相关，目前被认为是IgG4相关疾病的一种胆道表现。虽然2012年制定了IgG4-SC的临床诊断标准，但有时很难与原发性硬化性胆管炎和胆管癌相鉴别。此外，目前还没有关于IgG4-SC的实用指南。由于通过搜索PubMed、Cochrane图书馆和Igaku Chuo Zasshi数据库检索的大多数文章的证据水平低于C，基于2014年临床实践指南思维的系统审查评估系统，我们使用改进的Delphi方法开发了共识指南。组织了三个委员会(一个准则制定委员会、一个根据改进的德尔菲法进行评级陈述的专家小组委员会和一个评估委员会)。制定了18个带有临床陈述的临床问题(CQS)，涉及诊断(14个CQS)和治疗(4个CQS)。临床报告的推荐水平是使用改进的德尔菲法设定的。指南解释了准确诊断和安全适当治疗IgG4-SC的方法。
IgG4-related sclerosing cholangitis (IgG4-SC) is a distinct type of cholangitis frequently associated with autoimmune pancreatitis and currently recognized as a biliary manifestation of IgG4-related disease. Although clinical diagnostic criteria of IgG4-SC were established in 2012, differential diagnosis from primary sclerosing cholangitis and cholangiocarcinoma is sometimes difficult. Furthermore, no practical guidelines for IgG4-SC are available. Because the evidence level of most articles retrieved through searching the PubMed, Cochrane Library, and Igaku Chuo Zasshi databases was below C based on the systematic review evaluation system of clinical practice guidelines MINDS 2014, we developed consensus guidelines using the modified Delphi approach. Three committees (a guideline creating committee, an expert panelist committee for rating statements according to the modified Delphi method, and an evaluating committee) were organized. Eighteen clinical questions (CQs) with clinical statements were developed regarding diagnosis (14 CQs) and treatment (4 CQs). Recommendation levels for clinical statements were set using the modified Delphi approach. The guidelines explain methods for accurate diagnosis, and safe and appropriate treatment of IgG4-SC.