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
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DOI：
10.1136/gutjnl-2012-302779
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发表时间：
2013-01-01
期刊：
影响因子：
24.5
通讯作者：
Vege, Santhi Swaroop
中科院分区：
文献类型：
--
作者：
Banks, Peter A.;Bollen, Thomas L.;Vege, Santhi Swaroop
背景与目的急性胰腺炎的亚特兰大分类使研究报告标准化，并有助于临床医生之间的交流。缺陷的确定和提高认识的疾病作出必要的revision.Methods一个基于网络的咨询进行了2007年，以确保广泛参与的胰腺科医生。在首次会议后，工作组向11个国家和国际胰腺协会发送了一份文件草案。该工作草案已转交所有成员。根据评论意见进行了修订，并在网上进行了三次协商。对最终共识进行了审查，仅保留了基于已发表证据的声明。结果修订后的急性胰腺炎分类将疾病分为两个阶段：早期和晚期。严重程度分为轻度、中度或重度。轻度急性胰腺炎是最常见的形式，没有器官衰竭，局部或全身并发症，通常在第一周内消退。中重度急性胰腺炎的定义为存在一过性器官衰竭、局部并发症或共病加重。重症急性胰腺炎定义为持续性器官衰竭，即器官衰竭>48小时。局部并发症为胰周积液、胰腺和胰周坏死（无菌或感染）、假性囊肿和壁状坏死（无菌或感染）。我们提出了一个用于报告CT图像的标准化模板。结论这项基于网络的国际共识提供了使用易于识别的临床和放射学标准对急性胰腺炎进行分类的明确定义。胰腺学家之间的广泛协商，以达成这一共识，应鼓励广泛采用。
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.