Cited by 7,187Pancreatitis Pathology and TreatmentGallbladder and Bile Duct DisordersPancreatic and Hepatic Oncology Research

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

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Banks, Peter A, Bollen, Thomas L, Dervenis, Christos, Gooszen, Hein G, Johnson, Colin D, Sarr, Michael G, Tsiotos, Gregory G, Vege, Santhi Swaroop·2013·Gut

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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  • Major adverse cardiovascular events and acute pancreatitis were adjudicated centrally in a blinded manner.

    “Major adverse cardiovascular events and acute pancreatitis (according to the Atlanta criteria 14 ) were adjudicated centrally in a blinded manner.”
  • Acute pancreatitis occurred in 9 patients in the semaglutide group and 12 in the placebo group; all events were mild according to the revised Atlanta criteria.

    “Acute pancreatitis occurred in 9 patients in the semaglutide group and in 12 in the placebo group; all events were mild, according to the revised Atlanta criteria.7”
  • Acute pancreatitis episodes were independently adjudicated using the revised Atlanta criteria.

    “Episodes of acute pancreatitis were evaluated for safety and independently adjudicated according to the revised Atlanta criteria.17”

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  1. Sakorafas GH, Tsiotos GG, Sarr MG. Extrapancreatic necrotizing pancreatitis with viable pancreas: a previously under- appreciated entity. J Am Coll Surg 1999;188:643-8. [CrossRef] [Medline]
  2. Bradley EL III.. Atlanta redux. Pancreas 2003;26:105-6. [CrossRef] [Medline]

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Authors
Banks, P. A., Bollen, T. L., Dervenis, C., Gooszen, H. G., Johnson, C. D., Sarr, M. G., Tsiotos, G. G., & Vege, S. S.
Affiliations
  • Brigham and Women's Hospital (US)
  • St. Antonius Ziekenhuis (NL)
  • Agia Olga Hospital (GR)
  • Radboud University Nijmegen (NL)
  • University Hospital Southampton NHS Foundation Trust (GB)
  • Mayo Clinic (US)
  • Metropolitan Hospital (GR)
Corresponding author
Sarr, Michael G
Venue
Gut
Publisher
BMJ
Published
2012-10-25
Volume
62
Issue
1
Pages
102-111
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
OpenAlex
W2145758369
Cited by
7,187
References
77
Citations by year
2026: 666 · 2025: 732 · 2024: 720 · 2023: 738 · 2022: 699 · 2021: 675 · 2020: 612 · 2019: 481 · 2018: 458 · 2017: 402 · 2016: 349 · 2015: 305 · 2014: 232 · 2013: 91 · 2012: 9
FWCI
209.43
Type
journal article
Language
en
Open access
Locations
  • Gut (publishedVersion)
  • PubMed (publishedVersion)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • ResearchSpace (University of Auckland) (submittedVersion)
  • CONICET Digital (CONICET) (submittedVersion, cc-by-nc-sa)
Funders
  • University of Pittsburgh
  • American Gastroenterological Association
  • Cancer Research UK (15957)
  • National Institute for Health and Care Research (NF-SI-0510-10126)
  • Ministry of Urban Development
Topics
  • Health Sciences › Medicine › Surgery › Pancreatitis Pathology and Treatment
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Gallbladder and Bile Duct Disorders
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
Keywords
acute pancreatitis, Atlanta classification, disease severity classification, organ failure, local complications, pancreatic necrosis, peripancreatic fluid collections, pseudocyst, walled-off necrosis, international consensus
MeSH terms
Acute Disease, Humans, Pancreatitis, Severity of Illness Index, Tomography, X-Ray Computed, Disease Progression

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