Journal of Experimental and Clinical SurgeryJournal of Experimental and Clinical SurgeryВестник экспериментальной и клинической хирургии2070-478X2409-143XVoronezh State Medical University named after N.N. Burdenko155510.18499/2070-478X-2021-14-4-325-333Review of literatureОбзор литературыUnknownAtlanta 2012 Classification: Terminology and Definitions in the Diagnosis of Acute PancreatitisКлассификация Атланта–2012: терминология и определения при диагностике острого панкреатитаEktovVladimir NikolaevichЭктовВладимир Николаевич
Russian Federation

M.D., professor, Head of the Department of surgical disciplines of the Institute of Postgraduate Education

д.м.н., профессор, заведующий кафедрой хирургических дисциплин ИДПО

ektov.vladimir@yandex.ruKhodorkovskyMark AnatolievichХодорковскийМарк Анатольевич
Russian Federation

M.D., Professor of the Department of surgical disciplines of the Institute of Postgraduate Education

д.м.н., профессор, профессор кафедры хирургических дисциплин ИДПО

vgmi_30@mail.ruSkoryninOleg SergeevichСкорынинОлег Сергеевич
Russian Federation

Ph.D., Associate professor of the Department of surgical disciplines of the Institute of Postgraduate Education

к.м.н., доцент, доцент кафедры хирургических дисциплин ИДПО

skorynin13-29@mail.ruMinakovOleg EvgenievichМинаковОлег Евгеньевич
Russian Federation

Ph.D., Associate professor of the Department of surgical disciplines of the Institute of Postgraduate Education

к.м.н., доцент кафедры хирургических дисциплин ИДПО

minakov_oe@mail.ruN.N. Burdenko Voronezh state medical UniversityВоронежский государственный медицинский университет им. Н.Н. Бурденко1712202114432533310122021Copyright ©; 2021, Voronezh N.N. Burdenko State Medical UniversityCopyright ©; 2021, ФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава России2021Voronezh N.N. Burdenko State Medical UniversityФГБОУ ВО ВГМУ им. Н.Н. Бурденко Минздрава Россииhttps://vestnik-surgery.com/journal/about/editorialPolicieshttps://vestnik-surgery.com/journal/article/view/1555

The progress achieved in recent years in the treatment of acute pancreatitis (AP) is largely associated with the general views on understanding the key mechanisms of the disease development. The development of modern diagnostic and treatment technologies are based on the Atlanta 2012 classification of acute pancreatitis, which has received a global reach and widespread professional support. The review presents the key provisions of the Atlanta - 2012 classification according to the principles of AP diagnosis, classification of the disease, peculiarities of the radiation methods of examination in determining local complications and their morphological features. The publication emphasized the importance of timely stratification of the severity of AP based on the assessment of organ failure using a modified Marshall scale. Currently, the Atlanta 2012 classification has become a generally accepted international standard for assessing acute pancreatitis, which allows for effective multidisciplinary interaction of various specialists to optimize the results of treatment of this disease.

Достигнутый за последние годы прогресс в лечении острого панкреатита (ОП) в значительной мере связан с формированием общих взглядов на понимание ключевых механизмов развития этого заболевания. Базовым фундаментом для развития современных лечебно-диагностических технологий служит «классификация острого панкреатита Атланта-2012», получившая повсеместное распространение и широкую профессиональную поддержку. В обзоре приведены ключевые положения классификации Атланта – 2012 по принципам диагностики ОП, классификации заболевания, особенностям использования лучевых методов обследования в определении местных осложнений и их морфологической характеристики. В публикации подчеркнута важность своевременной стратификации степени тяжести ОП на основе оценки органной недостаточности с использованием модифицированной шкалы Маршалла. В настоящее время классификация Атланта-2012 стала общепринятым международным стандартом оценки острого панкреатита, позволяющим обеспечить эффективное мультидисциплинарное взаимодействие различных специалистов для оптимизации результатов лечения данного заболевания

acute pancreatitissevere acute pancreatitisclassification of acute pancreatitisseverity of acute pancreatitisострый панкреатиттяжелый острый панкреатитклассификация острого панкреатитастепень тяжести острого панкреатитаDas S, Mahakkanukrauh P, Ho CC. The burden of gastrointestinal, liver, and pancreatic diseases: the global scenario. Gastroenterology. 2016;150:1045–1046.Peery AF, Crockett SD, Barritt AS, et al. Burden of gastrointestinal, liver and pancreatic diseases in the United States. Gastroenterology. 2015;149:1731–1741Xiao AY. Global incidence and mortality of pancreatic diseases: a systematic review, metaanalysis, and meta-regression of population-based cohort studies. The Lancet Gastroenterology and Hepatology. 2016;1:45–55.Santvoort HC, Bakker OJ, Bollen TL. A conservative and minimally invasive approach to necrotizing pancreatitis improves outcome. Gastroenterology. 2011;141:1254 – 1263.Banks P, Bollen T, Dervenis C. Classification of acute pancreatitis— 2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62:102–11.Klinicheskie rekomendacii: Ostriy pancreatit. Rossiyskoe obshchestvo hirurgov, Associacia hepatopancreatobiliarnih hirurgov stran SNG. 2015; 38. (in Russ.)Клинические рекомендации: Острый панкреатит. Российское общество хирургов, Ассоциация гепатопанкреатобилиарных хирургов стран СНГ. 2015; 38.Banks PA, Freeman ML. Practice guidelines in acute pancreatitis. The American Journal of Gastroenterology. 2006;101:2379–400.Bollen TL, van Santvoort HC, Besselink MG. Update on acute pancreatitis: ultrasound, computed tomography, and magnetic resonance imaging features. Seminars of Ultrasound, CT and MRI. 2007;28:371–83.Tenner S, Baillie J, DeWitt J, Vege SS. American College of Gastroenterology. American College of Gastroenterology guideline: management of acute pancreatitis. The American Journal of Gastroenterology.2013;108:1400–15; 1416. doi.org/10.1038/ajg.2013.218.Uhl W, Warshaw A, Imrie C. IAP Guidelines for the surgical management of acute pancreatitis. Pancreatology. 2002;2:565–73.UK Working Party on Acute Pancreatitis. UK guidelines for the management of acute pancreatitis. Gut. 2005;54:iii1–9.Japanese guidelines for the management of acute pancreatitis: Japanese Guidelines 2015. Journal of Hepato-Biliary-Pancreatic Sciences. 2015; 22:405–432 https://doi.org/10.1002/jhbp.259.Lippi G, Valentino M, Cervellin G. Laboratory diagnosis of acute pancreatitis: insearch of the holygrail. Critical Reviews in Clinical Laboratiry Sciences. 2012;49:18–31. doi.org/10.3109/10408363.2012.658354.Rompianesi G, Hann A, Komolafe O, Pereira SP, Davidson BR, Gurusamy KS. Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis. Cochrane Database of Systematic Reviews. 2017;4: CD012010. doi.org/10.1002/14651858.CD012010.pub2.Arvanitakis М, Dumonceau JM, Albert J. Endoscopic management of acute necrotizing pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) evidence-based multidisciplinary guidelines. Endoscopy. 2018; 50: 524–546. doi.org/10.1055/a-0588-5365.Leppäniemi A, Tolonen M, Tarasconi А. 2019 WSES guidelines for the management of severe acute pancreatitis. World Journal of Emergency Surgery. 2019; 14:27. doi.org/10.1186/s13017-019-0247-0.Working Group IAP/APA Acute Pancreatitis Guidelines.IAP/APA evidence based guidelines for the management of acute pancreatitis. Pancreatology. 2013;13 (4 Suppl 2): e115. doi.org/10.1016/j.pan.2013.07.063.Yokoe M, Takada T, Mayumi T, Yoshida M, Isaji S, Wada K. Japanese guidelines for the management of acute pancreatitis: Japanese guidelines 2015. Journal of Hepato-Biliary-Pancreatic Sciences. 2015;22:405–32. doi.org/10.1002/jhbp.259.McPherson SJ, O'Reilly DA, Sinclair MT, Smith N. The use of imaging in acute pancreatitis in United Kingdom hospitals: findings from a national quality of care study. British Journal of Radiology. 2017;90(1080):20170224. doi.org/10.1259/bjr.20170224.Wang M, Wei A, Guo Q. Clinical outcomes of combined necrotizing pancreatitis versus extrapancreatic necrosis alone. Pancreatology. 2016; 16: 57 – 65.Balthazar EJ. Acute pancreatitis: assessment of severity with clinical and CT evaluation. Radiology.2002;223:603–13.Balthazar EJ, Robinson DL, Megibow AJ, Ranson JH. Acute pancreatitis: value of CT in establishing prognosis. Radiology.1990;174: 331–6.Besselink MG, van Santvoort HC, Boermeester MA, et al. Timing and impact of infections in acute pancreatitis. British Journal of Surgery. 2009;96:267–73.Perez A, Whang EE, Brooks DC. Is severity of necrotizing pancreatitis increased in extended necrosis and infected necrosis? Pancreas. 2002;25:229–33.Werge M, Novovic S, Schmidt PN, Gluud LL Infection increases mortality in necrotizing pancreatitis: a systematic review and meta-analysis. Pancreatology. 2016; 16(5):698–707.Marshall JC, Cook DJ, Christou NV. Multiple organ dysfunction score: a reliable descriptor of a complex clinical outcome. Critical Care Medicine. 1995;23:1638–52.Vincent JL, Moreno R, Takala J. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the working group on sepsis-related problems of the European Society of Intensive Care Medicine. Intensive Care Med 1996;22:707–10.Bollen TL, Besselink MG, vanSantvoort HC, Gooszen HG, vanLeeuwen MS. Toward an update of the Atlanta classification on acute pancreatitis: review of new and abandoned terms. Pancreas 2007;35(2):107–113.Dobbs NW, Budak MJ, Weir-McCall JR, Vinnicombe SJ, Zealley IA. Acute pancreatitis: a comparison of intervention ratesprecipitated by early vs guideline CT scan timing. Clinical radiology. 2016; 71 (10):993-996. doi.org/10.1016/j.crad.2016.06.113.Sandrasegaran K., Heller M., Panda A., Shetty A. Special section: pancreatitis. MRI in acute pancreatitis. Abdominal Radiology. 2019. doi.org/10.1007/s00261-019-02141-w.Shinagare AB, Ip IK, Raja AS, Sahni VA, Banks P, Khorasani R. Use of CT and MRI in emergency department patients with acute pancreatitis. Abdominal Imaging. 2015;40:272-7.Thoeni RF. The revised Atlanta classification of acute pancreatitis: its importance for the radiologist and its effect on treatment. Radiology. 2012; 262(3):751–64.Crockett S, Falck-Ytter Y, Wani S, Gardner TB. Acute Pancreatitis Guideline. Gastroenterology. 2018;154: 1102. doi: 10.1053/j.gastro.2018.02.029.Ektov VN. Model of stage-by-stage provision of medical and diagnostic care to patients with acute pancreatitis. Zhurnal Khirurg. 2019; 9: 12-25. (in Russ.)Эктов В.Н. Модель этапного оказания лечебно-диагностической помощи больным острым панкреатитом. Журнал Хирург. 2019; 9: 12-25.Baron T, DiMaio Ch, Wang A, Morgan K. American Gastroenterological Association Clinical Practice Update: Management of Pancreatic Necrosis. Gastroenterology. 2020;158:67–75. doi.org/10.1053/j.gastro.2019.07.064.Petrov MS, Windsor JA. Classification of the severity of acute pancreatitis: how many categories make sense? The American Journal of Gastroenterology. 2010;105:74–6.Vege SS, Gardner TB, Chari ST. Low mortality and high morbidity in severe acute pancreatitis without organ failure: a case for revising the Atlanta classification to include “moderately severe acute pancreatitis”. The American Journal of Gastroenterology. 2009;104:710–15.Singh VK, Bollen TL, Wu BU, et al. Anassessment of the severity of interstitial pancreatitis. Clinical Gastroenterology and Hepatology. 2011;9:1098–103.Garber A, Frakes C, Arora Z, Chahal P. Mechanisms and Management of Acute Pancreatitis. Gastroenterology Research and Practice. 2018; 2018: 6218798 DOI:10.1155/2018/6218798.Garg P. K.,Singh V. P.Organ Failure due to Systemic Injury in Acute Pancreatitis. Gastroenterology. 2019; 156(7):2008–2023. doi:10.1053/j.gastro.2018.12.041.Johnson CD, Abu-Hilal M. Persistent organ failure during the first week as a marker of fatal outcome in acute pancreatitis. Gut. 2004;53:1340–4.41.Mofidi R, Duff MD, Wigmore SJ. Association between early systemic inflammatory response, severity of multiorgan dysfunction and death in acute pancreatitis. British Journal of Surgery. 2006;93:738–44.Schepers NJ, Bakker OJ, Besselink MG, Ahmed Ali U, Bollen TL, Gooszen HG. Impact of characteristicsof organ failure and infected necrosis on mortality in necrotising pancreatitis. Gut. 2019; 68(6): 1044–51.Muckart DJ, Bhagwanjee S. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference definitions of the systemic inflammatory response syndrome and allied disorders in relation to critically injured patients. Critical Care Medicine. 1997;25 (11):1789–95.Sharma M, Banerjee D, Garg PK. Characterization of newer subgroups of fulminant and subfulminant pancreatitis associated with a high early mortality. The American Journal of Gastroenterology. 2007;102:2688–95.Carvalho JR, Fernandes SR, Santos P. Acute pancreatitis in the elderly: a cause for increased concern? Europian Journal of Gastroenterology and Hepatology. 2018;30:337–341.Krishna SG, Hinton A, Oza V. Morbid Obesity Is Associated With Adverse Clinical Outcomes in Acute Pancreatitis: A Propensity-Matched Study. The American Journal of Gastroenterology. 2015;110:1608–19.Dellinger EP, Forsmark CE, Layer P, Levy P, Maravi-Poma E, Petrov MS. Determinants-based classification of acute pancreatitis severity: an international multidisciplinary consultation. Annals of Surgery. 2012;256:875–80.Bansal SS, Hodson J, Sutcliffe RS.Performance of the revised Atlanta and determinant-based classification for severity in acutepancreatitis. British Journal of Surgery. 2016; 103: 427 – 433.Chen Y, Ke L, Tong Z. Association between severity and the Determinant-Based Classification, Atlanta 2012 and Atlanta 1992, in acute pancreatitis. A clinical retrospective study. Medicine. 2015;94:1 – 7.Fernandes SR, Carvalho J, Santos P. Atlanta, revised Atlanta, and Determinant-based classification-application in a cohort of Portuguese patients with acute pancreatitis. Europian Journal of Gastroenterology and Hepatology. 2016;28:20 – 24.Kadiyala V, Suleiman SL, McNabb-Baltar J. The Atlanta classification, revised Atlanta classification, and determinant-based classification of acute pancreatitis. Which is best at stratifying outcomes? Pancreas. 2016;45:510 – 515.Nawaz H, Mounzer R, Yadav D. Revised Atlanta and determinant based classification: application in a prospective cohort of acute pancreatitis patients. The American Journal of Gastroenterology. 2013;108:1911 – 1917.Acevedo-Piedra NG, Moya-Hoyo N, Rey-Riveiro M. Validation of the determinant-based classification and revision of the Atlanta classification systems for acute pancreatitis. Clinical Gastroenterology and Hepatology. 2014;12:311 – 316.Thandassery RB, Yadav TD, Dutta U.Prospective validation of 4-category classification of acute pancreatitis severity. Pancreas. 2013;42:392 – 396.Sternby H, Bolado F, Canaval-Zuleta HJ, Marra-Lopez C, Hernando-Alonso AI, Del-Val-Antonana A. Determinants of severity in acute pancreatitis: a nationwide multicenter prospective cohort study. Annals of Surgery. 2018;270(2):348–55.