International consensus on 2012 Atlanta classification and definition revision

Background: the Atlanta classification of acute pancreatitis enables the standardization of related research reports and facilitates the communication between clinicians. However, with the lack of understanding of the classification and further understanding of the disease, it is necessary to revise it.
Methods: a web-based discussion was conducted in 2007 to ensure the wide participation of pancreatologists. After the first meeting, the working group sent the draft to 11 countries and the international pancreatic society, which was transmitted to all members. Then make a revision based on the feedback. This kind of network discussion has been carried out three times. The final consensus was evaluated again and only the part supported by the literature was retained.

Results: the revised classification of acute pancreatitis identified two stages: early stage and late stage. The severity was divided into mild, moderate and severe. Mild acute pancreatitis is the most common type. There is no organ failure and local or systemic complications. It usually recovers in the first week of onset. Severe acute pancreatitis is defined as the presence of transient organ failure, local complications or deterioration of coexisting diseases. Severe acute pancreas is defined as persistent organ failure, that is, organ failure > 48 hours. Local complications included peripancreatic fluid accumulation, necrosis of pancreas and surrounding tissues (aseptic or infectious), pseudocyst and encapsulated necrosis (aseptic or infectious). We established the evaluation criteria of CT imaging.

Conclusion: this international, web-based consensus provides a clear definition for the classification of acute pancreatitis based on easy to judge clinical and imaging criteria, which should be encouraged to be widely used.