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

Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus
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 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.
0017-5749
102-111
Banks, P.A.
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Bollen, T.L.
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Dervenis, C.
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Gooszen, H.G.
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Johnson, C.D.
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Sarr, M.G.
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Tsiotos, G.G.
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Vege, S.S.
988c1f7a-10f1-4515-b44d-1a0fc0cf9783
Banks, P.A.
2e4e926d-69cd-4292-8d68-0ae41a7c1a79
Bollen, T.L.
a9cb1275-d376-4b36-808d-fd7ef09177b9
Dervenis, C.
4c980bd7-6fae-48fd-b524-2b9df91f4fb3
Gooszen, H.G.
26208c3c-8713-4412-8a7c-c537e3ca4204
Johnson, C.D.
e50aa9cd-8c61-4fe3-a0b3-f51cc3a6c74a
Sarr, M.G.
e2bed697-1849-45a2-829a-48f0bcad4776
Tsiotos, G.G.
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Vege, S.S.
988c1f7a-10f1-4515-b44d-1a0fc0cf9783

Banks, P.A., Bollen, T.L., Dervenis, C., Gooszen, H.G., Johnson, C.D., Sarr, M.G., Tsiotos, G.G. and Vege, S.S. (2013) Classification of acute pancreatitis—2012: revision of the Atlanta classification and definitions by international consensus. Gut, 62, 102-111. (doi:10.1136/gutjnl-2012-302779).

Record type: Article

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.

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Published date: 2013
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 352170
URI: https://eprints.soton.ac.uk/id/eprint/352170
ISSN: 0017-5749
PURE UUID: c9af2640-d369-4518-bb8d-44b766735311

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Date deposited: 07 May 2013 13:52
Last modified: 16 Jul 2019 21:34

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Contributors

Author: P.A. Banks
Author: T.L. Bollen
Author: C. Dervenis
Author: H.G. Gooszen
Author: C.D. Johnson
Author: M.G. Sarr
Author: G.G. Tsiotos
Author: S.S. Vege

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