| Title： | Expert consensus on diagnosis and treatment of acute biliary tract infections in the elderly |
| Edition： | Original |
| Classification： | Experts consensus |
| Field： | Diagnosis and Treatment |
| Countries and regions： | China |
| Guidelines users： | 普通外科、肝胆外科、消化内科、急诊科、老年科等相关科室 |
| Evidence classification method： | According to the Hierarchy of evidence and recommendation level of Oxford Evidence-based medicine Center, the evidence categories in this guide are as follows: Ⅰ a: Meta analysis evidence of randomized Scientific control with good homogeneity; Ib: Evidence from at least one randomized controlled trial with a narrow 95% CI in a single randomized controlled trial; In the Cohort study with the same single starting point, the follow-up rate was>80%; Ic: All traditional treatments are ineffective; All deaths or survival were reported in the series of case reports; IIa: Evidence from at least one controlled study; Retrospective Cohort study or Randomized controlled trial with control group as blank control; IIb: from at least one quasi experimental study of another type; Single Cohort study and poor quality randomized Scientific control; Randomized controlled trial with single retrospective cohort or control group as blank control; IIc: Outcome study; Ⅲ a: meta-analysis of Case–control study with good homogeneity; Ⅲ b: single Case–control study; Ⅳ: Series case analysis or poor quality Case–control study, follow-up rate<80%; V: Evidence from expert committee reports or clinical trials. |
| Development unit： | Hepatopancreatobiliary Commitee of Chinese Aging Well Association |
| Registration time: | 2023-06-27 |
| Registration number： | PREPARE-2023CN441 |
| Purpose of the guideline: | 急性胆道感染（Acute biliary infection，ABI）是以急性胆囊炎和急性胆管炎为代表的感染性疾病。是老年外科急腹症的常见病。重症感染可以导致胆囊穿孔、肝脓肿、感染性休克甚至死亡。有研究显示高龄胆道感染患者死亡率为4.2%-11.7%，施行急诊手术风险明显增加, 死亡率可高达11.9%-24.0%。由于受老年特有的生理学特点以及较多的合并症影响，老年急性胆道感染的病程复杂，治疗方式及预后均存在不确定性。目前国内外相关指南共识均没有针对老年人群急性胆道感染的推荐意见。 本项目拟依托中国老年保健协会肝胆胰外科专业委员会，与全国多家医院胆道专业医师分工合作，通过文献检索、筛选及评价，文献系统性综述的方式，撰写针对老年人急性胆道感染诊断与治疗策略的初稿。通过专家投票的方式进行进一步修订，形成包含指南推荐意见、专家同意情况、证据级别和指南推荐强度的老年急性胆道感染指南。并通过北京医院、国家老年医学中心、中国老年保健协会及《中华老年医学杂志》平台推广。 |
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