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

BANKS PA, BOLLEN TL, DERVENIS C, GOOSZEN HG, JOHNSON CD, SARR MG, TSIOTOS GG, VEGE SS; ACUTE PANCREATITIS CLASSIFICATION WORKING GROUP.; ACUTE PANCREATITIS CLASSIFICATION WORKING GROUP[CORPORATE AUTHOR]:ACOSTA; ... ; VACCARO, MARIA I. ; ...; ZYROMSKI, NICHOLAS J.

GUT - AN INTERNATIONAL JOURNAL OF GASTROENTEOROLOGY AND HEPATOLOGY

B M J PUBLISHING GROUP

Lugar: Londres; Año: 2013 vol. 62 p. 102 - 111

0017-5749

Gut. 2013 Jan;62(1):102-11. doi: 10.1136/gutjnl-2012-302779. Epub 2012 Oct 25.Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus.Banks PA, Bollen TL, Dervenis C, Gooszen HG, Johnson CD, Sarr MG, Tsiotos GG, Vege SS; Acute Pancreatitis Classification Working Group.Collaborators (124)Acosta JM, Amann ST, Andren-Sandberg A, Aranha GV, Asciutti S, Banks PA, Barauskas G, Baron TH Sr, Bassi C, Behrman S, Behms KE, Belliappa V, Berzin TM, Besselink MG, Bhasin DK, Biankin A, Bishop MD, Bollen TL, Bonini CJ, Bradley EL 3rd, Buechler M, Carter R, Cavestro GM, Chari ST, Chavez-Rodriguez JJ, da Cunha JE, D´Agostino H, De Campos T, Delakidis S, de-Madaria E, Deprez PH, Dervenis C, DiSario JA, Doria C, Falconi M, Fernandez-del Castillo C, Freeny PC, Frey CF, Friess H, Frossard JL, Fuchshuber P, Gallagher SF, Gardner TB, Garg PK, Ghattas G, Glasgow R, Gonzalez JA, Gooszen HG, Gress TM, Gumbs AA, Halliburton C, Helton S, Hill MC, Horvath KD, Hoyos S, Imrie CW, Isenmann R, Izbicki JR, Johnson CD, Karagiannis JA, Klar E, Kolokythas O, Lau J, Litvin AA, Longnecker DS, Lowenfels AB, Mackey R, Mah´Moud M, Malangoni M, McFadden DW, Mishra G, Moody FG, Morgan DE, Morinville V, Mortele KJ, Neoptolemos JP, Nordback I, Pap A, Papachristou GI, Parks R, Pedrazolli S, Pelaez-Luna M, Pezzilli R, Pitt HA, Prosanto C, Ramesh H, Ramirez FC, Raper SE, Rasheed A, Reed DN Jr, Romangnuolo J, Rossaak J, Sanabria J, Sarr MG, Schaefer C, Schmidt J, Schmidt PN, Serrablo A, Senkowski CK, Sharma M, Sigman KM, Singh P, Stefanidis G, Steinberg W, Steiner J, Strasberg S, Strum W, Takada T, Tanaka M, Thoeni RF, Tsiotos GG, Van Santvoort H, Vaccaro M, Vege SS, Villavicencio RL, Vrochides D, Wagner M, Warshaw AL, Wilcox CM, Windsor JA, Wysocki P, Yadav D, Zenilman ME, Zyromski NJ.AbstractBACKGROUND 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 classification 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 definitions to classify acute pancreatitis using easily identified clinical and radiologic criteria. The wide consultation among pancreatologists to reach this consensus should encourage widespread adoption.Comment inRevision of the Atlanta classification of acute pancreatitis: the editorial perspective. [Gut. 2013]Classifying an unpredictable disease: the revised Atlanta classification of acute pancreatitis. [Gut. 2013]Acute pancreatitis reclassified. [Gut. 2013]