Aafke H van Dijk1, Philip R de Reuver2, Marc G Besselink3, Kees J van Laarhoven2, Ewen M Harrison4, Stephen J Wigmore4, Tom J Hugh5, Marja A Boermeester3. 1. Department of Surgery, Academical Medical Center, Amsterdam, The Netherlands. Electronic address: a.h.vandijk@amc.nl. 2. Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Surgery, Academical Medical Center, Amsterdam, The Netherlands. 4. Clinical Surgery, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK. 5. Upper GI Surgical Unit, Royal North Shore Hospital, University of Sydney, Australia.
Abstract
BACKGROUND: Gallstone disease is a frequent disorder in the Western world with a prevalence of 10-20%. Recommendations for the assessment and management of gallstones vary internationally. The aim of this systematic review was to assess quality of guideline recommendations for treatment of gallstones. METHODS: PubMed, EMBASE and websites of relevant associations were systematically searched. Guidelines without a critical appraisal of literature were excluded. Quality of guidelines was determined using the AGREE II instrument. Recommendations without consensus or with low level of evidence were considered to define problem areas and clinical research gaps. RESULTS: Fourteen guidelines were included. Overall quality of guidelines was low, with a mean score of 57/100 (standard deviation 19). Five of 14 guidelines were considered suitable for use in clinical practice without modifications. Ten recommendations from all included guidelines were based on low level of evidence and subject to controversy. These included major topics, such as definition of symptomatic gallstones, indications for cholecystectomy and intraoperative cholangiography. CONCLUSION: Only five guidelines on gallstones are evidence-based and of a high quality, but even in these controversy exists on important topics. High quality evidence is needed in specific areas before an international guideline can be developed and endorsed worldwide.
BACKGROUND:Gallstone disease is a frequent disorder in the Western world with a prevalence of 10-20%. Recommendations for the assessment and management of gallstones vary internationally. The aim of this systematic review was to assess quality of guideline recommendations for treatment of gallstones. METHODS: PubMed, EMBASE and websites of relevant associations were systematically searched. Guidelines without a critical appraisal of literature were excluded. Quality of guidelines was determined using the AGREE II instrument. Recommendations without consensus or with low level of evidence were considered to define problem areas and clinical research gaps. RESULTS: Fourteen guidelines were included. Overall quality of guidelines was low, with a mean score of 57/100 (standard deviation 19). Five of 14 guidelines were considered suitable for use in clinical practice without modifications. Ten recommendations from all included guidelines were based on low level of evidence and subject to controversy. These included major topics, such as definition of symptomatic gallstones, indications for cholecystectomy and intraoperative cholangiography. CONCLUSION: Only five guidelines on gallstones are evidence-based and of a high quality, but even in these controversy exists on important topics. High quality evidence is needed in specific areas before an international guideline can be developed and endorsed worldwide.
Authors: S Vaccari; M Minghetti; A Lauro; M I Bellini; A Ussia; S Khouzam; I R Marino; M Cervellera; V D'Andrea; V Tonini Journal: Dig Dis Sci Date: 2022-03-22 Impact factor: 3.199
Authors: Sarah Z Wennmacker; Aafke H van Dijk; Joris H J Raessens; Cornelis J H M van Laarhoven; Joost P H Drenth; Philip R de Reuver; Iris D Nagtegaal Journal: Surg Endosc Date: 2018-09-10 Impact factor: 4.584
Authors: Aldo Bove; Paolo Panaccio; Raffaella di Renzo; Gino Palone; Marco Ricciardiello; Sara Ciuffreda; Giuseppe Bongarzoni Journal: Gastroenterol Rep (Oxf) Date: 2019-06-05
Authors: George A Antoniou; Dimitris Mavridis; Sofia Tsokani; Manuel López-Cano; Iván D Flórez; Melissa Brouwers; Sheraz R Markar; Gianfranco Silecchia; Nader K Francis; Stavros A Antoniou Journal: BMJ Open Date: 2020-08-11 Impact factor: 2.692