A comprehensive classification of invasive procedures for treating the local complications of acute pancreatitis based on visualization, route, and purpose

Pancreatology. 2011;11(4):406-13. doi: 10.1159/000328191. Epub 2011 Aug 31.


Background/aims: The lack of a system to classify invasive procedures to treat local complications of acute pancreatitis is an obstacle to comparing interventions. This study aimed to develop and validate a comprehensive multidisciplinary classification.

Methods: Standardized terminology was used to develop a classification of procedures based on three key components: how the lesion is visualized, the route used during the procedure, and the procedure's purpose. Gastroenterologists, radiologists, and surgeons (n = 22) from three New Zealand centers independently classified 15 published technique descriptions. Inter-rater reliability was calculated for each component. The classification's clarity, ease of use, and potential to achieve its objectives were rated on a Likert scale.

Results: The classification's clarity, ease of use, and potential to achieve its objectives had median scores of 4/5. Inter-rater reliability for visualization, route, and purpose components was substantial at 0.73 (95% CI 0.63-0.82), 0.79 (95% CI 0.70-0.87), and 0.64 (95% CI 0.53-0.74), respectively.

Conclusions: This article describes the development and validation of a comprehensive classification for the wide range of procedures used to treat the local complications of acute pancreatitis. It has substantial inter-rater reliability and high acceptability, which should enhance communication between clinicians and facilitate comparison between procedures.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Diagnostic Techniques, Surgical / classification*
  • Humans
  • Interdisciplinary Communication
  • Pancreatectomy / classification*
  • Pancreatectomy / methods
  • Pancreatitis, Acute Necrotizing / complications
  • Pancreatitis, Acute Necrotizing / surgery*
  • Reproducibility of Results
  • Terminology as Topic*
  • Vocabulary, Controlled*