[Classification of acute pancreatitis from a surgical viewpoint]

Since it has been not yet proved possible to establish an internationally accepted, uniform classification for inflammatory disorders of the pancreas, the present review contrasts and compares the various classifications for acute pancreatitis, and points out the advantages and disadvantages for surgeons in clinical practice. All the categories published so far have been based principally on five different classification criteria: the clinical course (e.g. acute, chronic) histological findings (e.g. oedematous, necrotising), aetiological factors (e.g. biliary ethyltoxic), biochemical parameters (not specifically) with prognostic value (e.g. CRP), or the morphology of the inflammatory process as shown on a CT scan. At present, a reliable, reproducible and clinically applicable classification of acute pancreatitis can only be achieved on the basis of the CT scan with concurrent intravenous contrast medium injections (contrast-enhanced computed tomography). A combination of clinical and CT findings has proven a valuable support for the surgeon, especially in defining the indications for surgery.