Surgical management of acute pancreatitis: Historical perspectives, challenges, and current management approaches

Table 1 Acute pancreatitis diagnosis, classification, and indications for surgery

	Criteria
Diagnosis of AP (any two)	Abdominal pain
	Serum lipase or amylase anomalies
	Characteristic radiological features
Mild AP1	No OF
	Absence of local or systemic complications
Moderately severe AP1	Transient OF (resolves in < 48 h)
	Local or systemic complications without persistent OF
Severe AP1	Persistent OF
Key indications for surgery	Infected necrosis
	Complications of pancreatitis
	Fistulas
	Pseudocyst
	Recurrent AP
	Abdominal compartment syndrome
	Systemic inflammatory response syndrome
	Acute necrotizing cholecystitis or intestinal ischemia
	Acute bleeding due to a failed endovascular approach

¹Revised Atlanta Classification.

AP: Acute pancreatitis; OF: Organ failure.