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

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 undertake...

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Published in	Gut Vol. 62; no. 1; pp. 102 - 111
Main Authors	Banks, Peter A, Bollen, Thomas L, Dervenis, Christos, Gooszen, Hein G, Johnson, Colin D, Sarr, Michael G, Tsiotos, Gregory G, Vege, Santhi Swaroop
Format	Journal Article Conference Proceeding
Language	English
Published	London BMJ Publishing Group Ltd and British Society of Gastroenterology 01.01.2013 BMJ Publishing Group BMJ Publishing Group LTD
Subjects	Abdomen Acute Disease Acute Pancreatitis Bacterial Infection Biological and medical sciences Classification Cysts Disease Progression Gangrene Gastroenterology. Liver. Pancreas. Abdomen Humans Liver. Biliary tract. Portal circulation. Exocrine pancreas Medical imaging Medical sciences NMR Nuclear magnetic resonance Other diseases. Semiology Pain Pancreas Pancreatic Disorders Pancreatic Pseudocyst Pancreatitis Pancreatitis - classification Pancreatitis - complications Pancreatitis - diagnosis Pancreatitis - diagnostic imaging Severity of Illness Index Tomography, X-Ray Computed Working groups Acute Classification Gastroenterology Pancreatitis Definition Digestive diseases Pancreatic disease
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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 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.
AbstractList	BACKGROUND AND OBJECTIVEThe 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.METHODSA 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.RESULTSThe 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.CONCLUSIONSThis 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. 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 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. 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. 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. 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. 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. Background and objectiveThe 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.MethodsA 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.ResultsThe 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 >48h. 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.ConclusionsThis 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.
Author	Dervenis, Christos Banks, Peter A Tsiotos, Gregory G Bollen, Thomas L Sarr, Michael G Gooszen, Hein G Johnson, Colin D Vege, Santhi Swaroop
Author_xml	– sequence: 1 givenname: Peter A surname: Banks fullname: Banks, Peter A email: sarr.michael@mayo.edu organization: Division of Gastroenterology, Hepatology, and Endoscopy, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA – sequence: 2 givenname: Thomas L surname: Bollen fullname: Bollen, Thomas L email: sarr.michael@mayo.edu organization: Department of Radiology, St Antonius Hospital, Nieuwegein, the Netherlands – sequence: 3 givenname: Christos surname: Dervenis fullname: Dervenis, Christos email: sarr.michael@mayo.edu organization: First Department of Surgery, Agia Olga Hospital, Athens, Greece – sequence: 4 givenname: Hein G surname: Gooszen fullname: Gooszen, Hein G email: sarr.michael@mayo.edu organization: Evidence-Based Surgery Research Unit, University of Nijmegen, Nijmegen, the Netherlands – sequence: 5 givenname: Colin D surname: Johnson fullname: Johnson, Colin D email: sarr.michael@mayo.edu organization: University Hospital Southampton, Southampton, UK – sequence: 6 givenname: Michael G surname: Sarr fullname: Sarr, Michael G email: sarr.michael@mayo.edu organization: Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA – sequence: 7 givenname: Gregory G surname: Tsiotos fullname: Tsiotos, Gregory G email: sarr.michael@mayo.edu organization: Division of Digestive Surgery, Metropolitan Hospital, Athens, Greece – sequence: 8 givenname: Santhi Swaroop surname: Vege fullname: Vege, Santhi Swaroop email: sarr.michael@mayo.edu organization: Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
BackLink	http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26748770$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/23100216$$D View this record in MEDLINE/PubMed
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Contributor	Longnecker, Daniel S Serrablo, Alejandro Pap, Akos Pezzilli, Raffaele Delakidis, Stergios Bonini, Claudio J Pitt, Henry A Romangnuolo, Joseph Isenmann, Ranier Freeny, Patrick C Litvin, Andrey A Sharma, Manik Tsiotos, Gregory G Strasberg, Steven Carter, Ross Prosanto, C Behms, Kevin E Mishra, Girish Frossard, Jean Louis Parks, Rowan Hill, Michael C Vege, Santhi Swaroop Villavicencio, Roberto L McFadden, David W Windsor, John A Biankin, Andrew Ramesh, H Stefanidis, Gerasimos Papachristou, Georgios I Singh, Pankaj Pelaez-Luna, Mario Johnson, Colin D Berzin, Tyler M Takada, Tadahiro Frey, Charles F Tanaka, Masao Fuchshuber, Pascal Helton, Scott Falconi, Massimo Gooszen, Hein G Imrie, Clem W Mackey, Richard Andren-Sandberg, Ake Wysocki, Peter Bishop, Michele D Zyromski, Nicholas J Ramirez, Francisco C Acosta, Juan M Chavez-Rodriguez, Juan J Nordback, Isto Halliburton, Cory Morgan, Desiree E D'Agostino, Horatio Garg, Pramod Kumar Cavestro, Giulia Martina Morinville, Veronique Van Santvoort, Hjalmar Besselink, Marc G H Thoeni, Ruedi F L Glasgow, Robe
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Copyright	Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2014 INIST-CNRS Copyright: 2012 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
Copyright_xml	– notice: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions – notice: 2014 INIST-CNRS – notice: Copyright: 2012 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions
CorporateAuthor	Acute Pancreatitis Classification Working Group
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Keywords	Acute Classification Gastroenterology Pancreatitis Definition Digestive diseases Pancreatic disease
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Snippet	Background and objective The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between... The Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians. Deficiencies identified... BACKGROUND AND OBJECTIVEThe Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians.... Background and objectiveThe Atlanta classification of acute pancreatitis enabled standardised reporting of research and aided communication between clinicians....
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SubjectTerms	Abdomen Acute Disease Acute Pancreatitis Bacterial Infection Biological and medical sciences Classification Cysts Disease Progression Gangrene Gastroenterology. Liver. Pancreas. Abdomen Humans Liver. Biliary tract. Portal circulation. Exocrine pancreas Medical imaging Medical sciences NMR Nuclear magnetic resonance Other diseases. Semiology Pain Pancreas Pancreatic Disorders Pancreatic Pseudocyst Pancreatitis Pancreatitis - classification Pancreatitis - complications Pancreatitis - diagnosis Pancreatitis - diagnostic imaging Severity of Illness Index Tomography, X-Ray Computed Working groups
Title	Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus
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