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. Acosta & 104 others Stephen 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

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

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Pancreatitis
Consensus
Referral and Consultation
Necrosis
Group Processes
Communication
Research

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Banks, P. A., Bollen, T. L., Dervenis, C., Gooszen, H. G., Johnson, C. D., Sarr, M. G., ... 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

Classification of acute pancreatitis - 2012 : Revision of the Atlanta classification and definitions by international consensus. / Banks, Peter A.; Bollen, Thomas L.; Dervenis, Christos; Gooszen, Hein G.; Johnson, Colin D.; Sarr, Michael G.; Tsiotos, Gregory G.; Vege, Santhi Swaroop; Windsor, John A.; Horvath, Karen D.; Mortele, Koenraad J.; Gardner, Timothy B.; Van Santvoort, Hjalmar; Pelaez-Luna, Mario; Yadav, Dhiraj; Stefanidis, Gerasimos; Delakidis, Stergios; Morgan, Desiree E.; Thoeni, Ruedi F L; Acosta, Juan M.; Amann, Stephen T.; Andren-Sandberg, Ake; Aranha, Gerard V.; Asciutti, Stefania; Barauskas, Giedrius; Baron, Todd H.; Bassi, Claudio; Behrman, Steven; Behrns, Kevin E.; Belliappa, Vikram; Berzin, Tyler M.; Besselink, Marc G H; Bhasin, Deepak Kumar; Biankin, Andrew; Bishop, Michele D.; Bonini, Claudio J.; Bradley, Edward L.; Buechler, Markus; Carter, Ross; Cavestro, Giulia Martina; Chari, Suresh T.; Chavez-Rodriguez, Juan J.; Da Cunha, Jose Eduardo; D'Agostino, Horatio; De Campos, Tercio; De-Madaria, Enrique; Deprez, Pierre H.; DiSario, James A.; Doria, Cataldo; Falconi, Massimo; Fernandez-del Castillo, Carlos; Freeny, Patrick C.; Frey, Charles F.; Friess, Helmut; Frossard, Jean Louis; Fuchshuber, Pascal; Gallagher, Scott F.; Garg, Pramod Kumar; Ghattas, Georges; Glasgow, Robert; Gonzalez, Jose A.; Gress, Thomas M.; Gumbs, Andrew A.; Hallibruton, Cory; Helton, Scott; Hill, Michael C.; Hoyos, Sergio; Imrie, Clem W.; Isenmann, Ranier; Izbicki, Jakob R.; Karagiannis, John A.; Klar, Ernst; Kolokythas, Orpheus; Lau, Joseph; Litvin, Andrey A.; Longnecker, Daniel S.; Lowenfels, Albert B.; Mackey, Richard; Mah'Moud, Mitchell; Malangoni, Mark; McFadden, David W.; Mishra, Girish; Moody, Frank G.; Morinville, Veronique; Neoptolemos, John P.; Nordback, Isto; Pap, Akos; Papachristou, Georgios I.; Parks, Rowan; Pedrazolli, Sergio; Pezzilli, Raffaele; Pitt, Henry A.; Prosanto, C.; Ramesh, H.; Ramirez, Francisco C.; Raper, Steven E.; Rasheed, Ashraf; Reed, Donald N.; Romangnuolo, Joseph; Rossaak, Jeremy; Sanabria, Juan; Schaefer, Claus; Schmidt, Johannes; Schmidt, Palle Nordblad; Serrablo, Alejandro; Senkowski, Christopher K.; Sharma, Manik; Sigman, Ken M.; Singh, Pankaj; Steinberg, William; Steiner, Joerg; Strasberg, Steven; Strum, Williamson; Takada, Tadahiro; Tanaka, Masao; Vaccaro, Maria; Villavicencio, Roberto L.; Vrochides, Dionisios; Wagner, Markus; Warshaw, Andrew L.; Wilcox, Charles M.; Wysocki, Peter; Zenilman, Michael E.; Zyromski, Nicholas J.

In: Gut, Vol. 62, No. 1, 01.2013, p. 102-111.

Research output: Contribution to journalArticle

Banks, PA, Bollen, TL, Dervenis, C, Gooszen, HG, Johnson, CD, Sarr, MG, Tsiotos, GG, Vege, SS, Windsor, JA, Horvath, KD, Mortele, KJ, Gardner, TB, Van Santvoort, H, Pelaez-Luna, M, Yadav, D, Stefanidis, G, Delakidis, S, Morgan, DE, Thoeni, RFL, Acosta, JM, Amann, ST, Andren-Sandberg, A, Aranha, GV, Asciutti, S, Barauskas, G, Baron, TH, Bassi, C, Behrman, S, Behrns, KE, Belliappa, V, Berzin, TM, Besselink, MGH, Bhasin, DK, Biankin, A, Bishop, MD, Bonini, CJ, Bradley, EL, Buechler, M, Carter, R, Cavestro, GM, Chari, ST, Chavez-Rodriguez, JJ, Da Cunha, JE, D'Agostino, H, De Campos, T, De-Madaria, E, Deprez, PH, DiSario, JA, Doria, C, Falconi, M, Fernandez-del Castillo, C, Freeny, PC, Frey, CF, Friess, H, Frossard, JL, Fuchshuber, P, Gallagher, SF, Garg, PK, Ghattas, G, Glasgow, R, Gonzalez, JA, Gress, TM, Gumbs, AA, Hallibruton, C, Helton, S, Hill, MC, Hoyos, S, Imrie, CW, Isenmann, R, Izbicki, JR, 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, Morinville, V, Neoptolemos, JP, Nordback, I, Pap, A, Papachristou, GI, Parks, R, Pedrazolli, S, Pezzilli, R, Pitt, HA, Prosanto, C, Ramesh, H, Ramirez, FC, Raper, SE, Rasheed, A, Reed, DN, Romangnuolo, J, Rossaak, J, Sanabria, J, Schaefer, C, Schmidt, J, Schmidt, PN, Serrablo, A, Senkowski, CK, Sharma, M, Sigman, KM, Singh, P, Steinberg, W, Steiner, J, Strasberg, S, Strum, W, Takada, T, Tanaka, M, Vaccaro, M, Villavicencio, RL, Vrochides, D, Wagner, M, Warshaw, AL, Wilcox, CM, Wysocki, P, Zenilman, ME & Zyromski, NJ 2013, 'Classification of acute pancreatitis - 2012: Revision of the Atlanta classification and definitions by international consensus', Gut, vol. 62, no. 1, pp. 102-111. https://doi.org/10.1136/gutjnl-2012-302779
Banks, Peter A. ; Bollen, Thomas L. ; Dervenis, Christos ; Gooszen, Hein G. ; Johnson, Colin D. ; Sarr, Michael G. ; Tsiotos, Gregory G. ; Vege, Santhi Swaroop ; Windsor, John A. ; Horvath, Karen D. ; Mortele, Koenraad J. ; Gardner, Timothy B. ; Van Santvoort, Hjalmar ; Pelaez-Luna, Mario ; Yadav, Dhiraj ; Stefanidis, Gerasimos ; Delakidis, Stergios ; Morgan, Desiree E. ; Thoeni, Ruedi F L ; Acosta, Juan M. ; Amann, Stephen T. ; Andren-Sandberg, Ake ; Aranha, Gerard V. ; Asciutti, Stefania ; Barauskas, Giedrius ; Baron, Todd H. ; Bassi, Claudio ; Behrman, Steven ; Behrns, Kevin E. ; Belliappa, Vikram ; Berzin, Tyler M. ; Besselink, Marc G H ; Bhasin, Deepak Kumar ; Biankin, Andrew ; Bishop, Michele D. ; Bonini, Claudio J. ; Bradley, Edward L. ; Buechler, Markus ; Carter, Ross ; Cavestro, Giulia Martina ; Chari, Suresh T. ; Chavez-Rodriguez, Juan J. ; Da Cunha, Jose Eduardo ; D'Agostino, Horatio ; De Campos, Tercio ; De-Madaria, Enrique ; Deprez, Pierre H. ; DiSario, James A. ; Doria, Cataldo ; Falconi, Massimo ; Fernandez-del Castillo, Carlos ; Freeny, Patrick C. ; Frey, Charles F. ; Friess, Helmut ; Frossard, Jean Louis ; Fuchshuber, Pascal ; Gallagher, Scott F. ; Garg, Pramod Kumar ; Ghattas, Georges ; Glasgow, Robert ; Gonzalez, Jose A. ; Gress, Thomas M. ; Gumbs, Andrew A. ; Hallibruton, Cory ; Helton, Scott ; Hill, Michael C. ; Hoyos, Sergio ; Imrie, Clem W. ; Isenmann, Ranier ; Izbicki, Jakob R. ; Karagiannis, John A. ; Klar, Ernst ; Kolokythas, Orpheus ; Lau, Joseph ; Litvin, Andrey A. ; Longnecker, Daniel S. ; Lowenfels, Albert B. ; Mackey, Richard ; Mah'Moud, Mitchell ; Malangoni, Mark ; McFadden, David W. ; Mishra, Girish ; Moody, Frank G. ; Morinville, Veronique ; Neoptolemos, John P. ; Nordback, Isto ; Pap, Akos ; Papachristou, Georgios I. ; Parks, Rowan ; Pedrazolli, Sergio ; Pezzilli, Raffaele ; Pitt, Henry A. ; Prosanto, C. ; Ramesh, H. ; Ramirez, Francisco C. ; Raper, Steven E. ; Rasheed, Ashraf ; Reed, Donald N. ; Romangnuolo, Joseph ; Rossaak, Jeremy ; Sanabria, Juan ; Schaefer, Claus ; Schmidt, Johannes ; Schmidt, Palle Nordblad ; Serrablo, Alejandro ; Senkowski, Christopher K. ; Sharma, Manik ; Sigman, Ken M. ; Singh, Pankaj ; Steinberg, William ; Steiner, Joerg ; Strasberg, Steven ; Strum, Williamson ; Takada, Tadahiro ; Tanaka, Masao ; Vaccaro, Maria ; Villavicencio, Roberto L. ; Vrochides, Dionisios ; Wagner, Markus ; Warshaw, Andrew L. ; Wilcox, Charles M. ; Wysocki, Peter ; Zenilman, Michael E. ; Zyromski, Nicholas J. / Classification of acute pancreatitis - 2012 : Revision of the Atlanta classification and definitions by international consensus. In: Gut. 2013 ; Vol. 62, No. 1. pp. 102-111.
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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.",
author = "Banks, {Peter A.} and Bollen, {Thomas L.} and Christos Dervenis and Gooszen, {Hein G.} and Johnson, {Colin D.} and Sarr, {Michael G.} and Tsiotos, {Gregory G.} and Vege, {Santhi Swaroop} and Windsor, {John A.} and Horvath, {Karen D.} and Mortele, {Koenraad J.} and Gardner, {Timothy B.} and {Van Santvoort}, Hjalmar and Mario Pelaez-Luna and Dhiraj Yadav and Gerasimos Stefanidis and Stergios Delakidis and Morgan, {Desiree E.} and Thoeni, {Ruedi F L} and Acosta, {Juan M.} and Amann, {Stephen T.} and Ake Andren-Sandberg and Aranha, {Gerard V.} and Stefania Asciutti and Giedrius Barauskas and Baron, {Todd H.} and Claudio Bassi and Steven Behrman and Behrns, {Kevin E.} and Vikram Belliappa and Berzin, {Tyler M.} and Besselink, {Marc G H} and Bhasin, {Deepak Kumar} and Andrew Biankin and Bishop, {Michele D.} and Bonini, {Claudio J.} and Bradley, {Edward L.} and Markus Buechler and Ross Carter and Cavestro, {Giulia Martina} and Chari, {Suresh T.} and Chavez-Rodriguez, {Juan J.} and {Da Cunha}, {Jose Eduardo} and Horatio D'Agostino and {De Campos}, Tercio and Enrique De-Madaria and Deprez, {Pierre H.} and DiSario, {James A.} and Cataldo Doria and Massimo Falconi and {Fernandez-del Castillo}, Carlos and Freeny, {Patrick C.} and Frey, {Charles F.} and Helmut Friess and Frossard, {Jean Louis} and Pascal Fuchshuber and Gallagher, {Scott F.} and Garg, {Pramod Kumar} and Georges Ghattas and Robert Glasgow and Gonzalez, {Jose A.} and Gress, {Thomas M.} and Gumbs, {Andrew A.} and Cory Hallibruton and Scott Helton and Hill, {Michael C.} and Sergio Hoyos and Imrie, {Clem W.} and Ranier Isenmann and Izbicki, {Jakob R.} and Karagiannis, {John A.} and Ernst Klar and Orpheus Kolokythas and Joseph Lau and Litvin, {Andrey A.} and Longnecker, {Daniel S.} and Lowenfels, {Albert B.} and Richard Mackey and Mitchell Mah'Moud and Mark Malangoni and McFadden, {David W.} and Girish Mishra and Moody, {Frank G.} and Veronique Morinville and Neoptolemos, {John P.} and Isto Nordback and Akos Pap and Papachristou, {Georgios I.} and Rowan Parks and Sergio Pedrazolli and Raffaele Pezzilli and Pitt, {Henry A.} and C. Prosanto and H. Ramesh and Ramirez, {Francisco C.} and Raper, {Steven E.} and Ashraf Rasheed and Reed, {Donald N.} and Joseph Romangnuolo and Jeremy Rossaak and Juan Sanabria and Claus Schaefer and Johannes Schmidt and Schmidt, {Palle Nordblad} and Alejandro Serrablo and Senkowski, {Christopher K.} and Manik Sharma and Sigman, {Ken M.} and Pankaj Singh and William Steinberg and Joerg Steiner and Steven Strasberg and Williamson Strum and Tadahiro Takada and Masao Tanaka and Maria Vaccaro and Villavicencio, {Roberto L.} and Dionisios Vrochides and Markus Wagner and Warshaw, {Andrew L.} and Wilcox, {Charles M.} and Peter Wysocki and Zenilman, {Michael E.} and Zyromski, {Nicholas J.}",
year = "2013",
month = "1",
doi = "10.1136/gutjnl-2012-302779",
language = "English (US)",
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pages = "102--111",
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TY - JOUR

T1 - Classification of acute pancreatitis - 2012

T2 - Revision of the Atlanta classification and definitions by international consensus

AU - Banks, Peter A.

AU - Bollen, Thomas L.

AU - Dervenis, Christos

AU - Gooszen, Hein G.

AU - Johnson, Colin D.

AU - Sarr, Michael G.

AU - Tsiotos, Gregory G.

AU - Vege, Santhi Swaroop

AU - Windsor, John A.

AU - Horvath, Karen D.

AU - Mortele, Koenraad J.

AU - Gardner, Timothy B.

AU - Van Santvoort, Hjalmar

AU - Pelaez-Luna, Mario

AU - Yadav, Dhiraj

AU - Stefanidis, Gerasimos

AU - Delakidis, Stergios

AU - Morgan, Desiree E.

AU - Thoeni, Ruedi F L

AU - Acosta, Juan M.

AU - Amann, Stephen T.

AU - Andren-Sandberg, Ake

AU - Aranha, Gerard V.

AU - Asciutti, Stefania

AU - Barauskas, Giedrius

AU - Baron, Todd H.

AU - Bassi, Claudio

AU - Behrman, Steven

AU - Behrns, Kevin E.

AU - Belliappa, Vikram

AU - Berzin, Tyler M.

AU - Besselink, Marc G H

AU - Bhasin, Deepak Kumar

AU - Biankin, Andrew

AU - Bishop, Michele D.

AU - Bonini, Claudio J.

AU - Bradley, Edward L.

AU - Buechler, Markus

AU - Carter, Ross

AU - Cavestro, Giulia Martina

AU - Chari, Suresh T.

AU - Chavez-Rodriguez, Juan J.

AU - Da Cunha, Jose Eduardo

AU - D'Agostino, Horatio

AU - De Campos, Tercio

AU - De-Madaria, Enrique

AU - Deprez, Pierre H.

AU - DiSario, James A.

AU - Doria, Cataldo

AU - Falconi, Massimo

AU - Fernandez-del Castillo, Carlos

AU - Freeny, Patrick C.

AU - Frey, Charles F.

AU - Friess, Helmut

AU - Frossard, Jean Louis

AU - Fuchshuber, Pascal

AU - Gallagher, Scott F.

AU - Garg, Pramod Kumar

AU - Ghattas, Georges

AU - Glasgow, Robert

AU - Gonzalez, Jose A.

AU - Gress, Thomas M.

AU - Gumbs, Andrew A.

AU - Hallibruton, Cory

AU - Helton, Scott

AU - Hill, Michael C.

AU - Hoyos, Sergio

AU - Imrie, Clem W.

AU - Isenmann, Ranier

AU - Izbicki, Jakob R.

AU - Karagiannis, John A.

AU - Klar, Ernst

AU - Kolokythas, Orpheus

AU - Lau, Joseph

AU - Litvin, Andrey A.

AU - Longnecker, Daniel S.

AU - Lowenfels, Albert B.

AU - Mackey, Richard

AU - Mah'Moud, Mitchell

AU - Malangoni, Mark

AU - McFadden, David W.

AU - Mishra, Girish

AU - Moody, Frank G.

AU - Morinville, Veronique

AU - Neoptolemos, John P.

AU - Nordback, Isto

AU - Pap, Akos

AU - Papachristou, Georgios I.

AU - Parks, Rowan

AU - Pedrazolli, Sergio

AU - Pezzilli, Raffaele

AU - Pitt, Henry A.

AU - Prosanto, C.

AU - Ramesh, H.

AU - Ramirez, Francisco C.

AU - Raper, Steven E.

AU - Rasheed, Ashraf

AU - Reed, Donald N.

AU - Romangnuolo, Joseph

AU - Rossaak, Jeremy

AU - Sanabria, Juan

AU - Schaefer, Claus

AU - Schmidt, Johannes

AU - Schmidt, Palle Nordblad

AU - Serrablo, Alejandro

AU - Senkowski, Christopher K.

AU - Sharma, Manik

AU - Sigman, Ken M.

AU - Singh, Pankaj

AU - Steinberg, William

AU - Steiner, Joerg

AU - Strasberg, Steven

AU - Strum, Williamson

AU - Takada, Tadahiro

AU - Tanaka, Masao

AU - Vaccaro, Maria

AU - Villavicencio, Roberto L.

AU - Vrochides, Dionisios

AU - Wagner, Markus

AU - Warshaw, Andrew L.

AU - Wilcox, Charles M.

AU - Wysocki, Peter

AU - Zenilman, Michael E.

AU - Zyromski, Nicholas J.

PY - 2013/1

Y1 - 2013/1

N2 - 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.

AB - 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.

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U2 - 10.1136/gutjnl-2012-302779

DO - 10.1136/gutjnl-2012-302779

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JO - Gut

JF - Gut

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IS - 1

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