International Multidisciplinary Consensus Report on Definitions, Diagnostic Criteria, and Management of Fatty Pancreas: A Joint Statement Endorsed by EPC, APA, EASD, EASL, ESGAR, ESGE, ESP, ESPCG, ESPEN, ESPGHAN, IAP, JPS, KPBA, LAPSG, and UEG
Miroslav Vujasinović, İhsan Ekin Demir, Giovanni Marchegiani, Peter Hegyi, Livia Archibugi, Roberto Valente, Gabriele Capurso, Heiko Witt, Stefanos Bonovas, Daniele Piovani, Jonas Rosendahl, Patrick Maisonneuve, Caroline S. Verbeke, Muşturay Karçaaltıncaba, J. Enrique Dominguez‐Muñoz, Isabelle Scheers, László Czakó, R Wagner, Vinciane Rebours, Daniel Öhlund, Ilkay S. Idılman, Kasper A. Overbeek, N. B. Gubergrits, Trond Engjom, Albrecht Neeße, Minoti V. Apte, Mihailo Bezmarević, Rickmer Braren, Stefania Bunduc, Güralp Onur Ceyhan, Manil Dinesh Chouhan, Anne Couvelard, Jérôme Cros, Daniel de la Iglesia, Enrique de‐Madaria, Joost P. H. Drenth, Asbjørn Mohr Drewes, A. Farina Sarasqueta, Pierluigi Fracasso, Sven Francque, Jens Brøndum Frøkjær, Julio Iglesias‐Garcia, Pramod Garg, Felicia Gerst, Antanas Gulbinas, Ibrahim Halil Gürcinar, Martin Heni, Jong Jin Hyun, E G Jonas, Mariia Kiriukova, M. Kitano, Aleksander Krag, J. Laukkarinen, Mónika Lipp, M. Loveček, Marc E. Martignoni, Etna Masip, Ryotaro Matsumoto, Anders Molven, T. L. Mozhynа, Lenka Nosáková, Verena Carola Obmann, Johann Ockenga, Sanjay Pandanaboyana, Nikola Panić, Georgios Papachristou, Analía V. Pasqua, Katarzyna Monika Pawlak, Mario Peláez‐Luna, Ivonne Regel, Sara Regnér, Stuart Robinson, Andrada Seicean, Vijay Kumar Singh, M. Smits, Min Je Sung, Matteo Tacelli, Roy Taylor, Brigitta Teutsch, Mihaela Udrescu, Michael Wilschanski, Aslihan Yavas, G. Zamboni, J. Matthias Löhr
Abstract
This international, multidisciplinary consensus report represents the first effort to systematically define and characterize fatty pancreas. A key outcome of this endeavor was the recommendation to adopt "fatty pancreas" as the standardized and inclusive term to describe all forms of fat accumulation in the pancreas. This terminological consensus provides a critical foundation for unified reporting and clinical communication. Another major contribution of the report is the consensus on diagnostic imaging findings, which was based on radiological and endoscopic modalities. The proposed criteria aim to enhance consistency in clinical assessment and support the development of standardized research protocols. In addition to establishing terminology and diagnostic frameworks, the report also synthesizes current knowledge across a wide range of relevant domains. These include the etiology and epidemiology of fatty pancreas, as well as its associations with alcohol consumption, smoking, acute and chronic pancreatitis, pancreatic exocrine insufficiency, type 2 diabetes mellitus, and surgical outcomes. The potential links between fatty pancreas and neoplastic conditions such as intraductal papillary mucinous neoplasms and pancreatic cancer are also addressed, alongside the current understanding of its metabolic implications (beta-cell function and glucose homeostasis) and treatment strategies. Throughout the consensus process, a consistent theme emerged: the limited availability of high-quality, prospective clinical data. Therefore, many of the recommendations in this report are based on expert consensus rather than strong empirical evidence. As such, the statements require rigorous prospective validation before they can be adopted into routine clinical practice. This underscores a critical need for further research, particularly studies aimed at clarifying causal relationships, validating diagnostic tools, and determining the clinical relevance of fatty pancreas across diverse patient populations. This report serves as both a summary of our current understanding and a roadmap for future investigations, aiming to close existing knowledge gaps and guide evidence-based clinical practice in this emerging field.