Classification of acute pancreatitis - 2012: Revision of the Atlanta classification and definitions by international consensus

Peter A. Banks, Thomas L. Bollen, Christos Dervenis, Hein G. Gooszen, Colin D. Johnson, Michael G. Sarr, Gregory G. Tsiotos, Santhi Swaroop Vege, John A. Windsor, Karen D. Horvath, Koenraad J. Mortele, Timothy B. Gardner, Hjalmar Van Santvoort, Mario Pelaez-Luna, Dhiraj Yadav, Gerasimos Stefanidis, Stergios Delakidis, Desiree E. Morgan, Ruedi F.L. Thoeni, Juan M. AcostaStephen T. Amann, Ake Andren-Sandberg, Gerard V. Aranha, Stefania Asciutti, Giedrius Barauskas, Todd H. Baron, Claudio Bassi, Steven Behrman, Kevin E. Behrns, Vikram Belliappa, Tyler M. Berzin, Marc G.H. Besselink, Deepak Kumar Bhasin, Andrew Biankin, Michele D. Bishop, Claudio J. Bonini, Edward L. Bradley, Markus Buechler, Ross Carter, Giulia Martina Cavestro, Suresh T. Chari, Juan J. Chavez-Rodriguez, Jose Eduardo Da Cunha, Horatio D'Agostino, Tercio De Campos, Enrique De-Madaria, Pierre H. Deprez, James A. DiSario, Cataldo Doria, Massimo Falconi, Carlos Fernandez-del Castillo, Patrick C. Freeny, Charles F. Frey, Helmut Friess, Jean Louis Frossard, Pascal Fuchshuber, Scott F. Gallagher, Pramod Kumar Garg, Georges Ghattas, Robert Glasgow, Jose A. Gonzalez, Thomas M. Gress, Andrew A. Gumbs, Cory Hallibruton, Scott Helton, Michael C. Hill, Sergio Hoyos, Clem W. Imrie, Ranier Isenmann, Jakob R. Izbicki, John A. Karagiannis, Ernst Klar, Orpheus Kolokythas, Joseph Lau, Andrey A. Litvin, Daniel S. Longnecker, Albert B. Lowenfels, Richard Mackey, Mitchell Mah'Moud, Mark Malangoni, David W. McFadden, Girish Mishra, Frank G. Moody, Veronique Morinville, John P. Neoptolemos, Isto Nordback, Akos Pap, Georgios I. Papachristou, Rowan Parks, Sergio Pedrazolli, Raffaele Pezzilli, Henry A. Pitt, C. Prosanto, H. Ramesh, Francisco C. Ramirez, Steven E. Raper, Ashraf Rasheed, Donald N. Reed, Joseph Romangnuolo, Jeremy Rossaak, Juan Sanabria, Claus Schaefer, Johannes Schmidt, Palle Nordblad Schmidt, Alejandro Serrablo, Christopher K. Senkowski, Manik Sharma, Ken M. Sigman, Pankaj Singh, William Steinberg, Joerg Steiner, Steven Strasberg, Williamson Strum, Tadahiro Takada, Masao Tanaka, Maria Vaccaro, Roberto L. Villavicencio, Dionisios Vrochides, Markus Wagner, Andrew L. Warshaw, Charles M. Wilcox, Peter Wysocki, Michael E. Zenilman, Nicholas J. Zyromski

Research output: Contribution to journalArticle

2214 Scopus citations

Abstract

Background and objective: The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians. Deficiencies identified and improved understanding of the disease make a revision necessary. Methods: A web-based consultation was undertaken in 2007 to ensure wide participation of pancreatologists. After an initial meeting, the Working Group sent a draft document to 11 national and international pancreatic associations. This working draft was forwarded to all members. Revisions were made in response to comments, and the web-based consultation was repeated three times. The final consensus was reviewed, and only statements based on published evidence were retained. Results: The revised classi fication of acute pancreatitis identified two phases of the disease: early and late. Severity is classified as mild, moderate or severe. Mild acute pancreatitis, the most common form, has no organ failure, local or systemic complications and usually resolves in the first week. Moderately severe acute pancreatitis is defined by the presence of transient organ failure, local complications or exacerbation of co-morbid disease. Severe acute pancreatitis is defined by persistent organ failure, that is, organ failure >48 h. Local complications are peripancreatic fluid collections, pancreatic and peripancreatic necrosis (sterile or infected), pseudocyst and walled-off necrosis (sterile or infected). We present a standardised template for reporting CT images. Conclusions: This international, web-based consensus provides clear de finitions to classify acute pancreatitis using easily identified clinical and radiologic criteria. The wide consultation among pancreatologists to reach this consensus should encourage widespread adoption.

Original languageEnglish
Pages (from-to)102-111
Number of pages10
JournalGut
Volume62
Issue number1
DOIs
StatePublished - Jan 1 2013
Externally publishedYes

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    Banks, P. A., Bollen, T. L., Dervenis, C., Gooszen, H. G., Johnson, C. D., Sarr, M. G., Tsiotos, G. G., Vege, S. S., Windsor, J. A., Horvath, K. D., Mortele, K. J., Gardner, T. B., Van Santvoort, H., Pelaez-Luna, M., Yadav, D., Stefanidis, G., Delakidis, S., Morgan, D. E., Thoeni, R. F. L., ... Zyromski, N. J. (2013). Classification of acute pancreatitis - 2012: Revision of the Atlanta classification and definitions by international consensus. Gut, 62(1), 102-111. https://doi.org/10.1136/gutjnl-2012-302779