The Pancreas An Integrated Textbook of Basic Science Medicine and Surgery 3rd Edition by Markus Lerch,John Neopt,Hans Beger,Andrew Warshaw,Markus Buchler,Ralph Hruban 9781119188414 1119188415

Section 1: Anatomy of the Pancreas

1 Development of the Pancreas and Related Structures

Anatomy of the Pancreas

Organogenesis in the Region of the Pancreas

Early Pancreatic Development

Differentiation of Pancreas Cell Types

Transcriptional Mechanisms Underlying Pancreatic Cell Fate Decision

Development and Disease

Acknowledgment

References

2 Anatomy, Histology, and Fine Structure of the Pancreas

Introduction

Gross Anatomy

Histology and Ultrastructure

Endocrine Pancreas

Acknowledgments

References

3 Congenital and Inherited Anomalies of the Pancreas

Introduction

Primary Malformations

Isolated Congenital Disorders of Pancreatic Endocrine Function

Other Hereditary Disorders with Variable Pancreatic Involvement and Metabolic Diseases Affecting the Pancreas

Inherited Metabolic Disorders Affecting the Pancreas

References

Section 2: Physiology and Pathophysiology of Pancreatic Functions

4 Physiology of Acinar Cell Secretion

Introduction

Composition of Pancreatic Acinar Juice

Acinar Fluid and Enzyme Secretion

Ca Signaling

Organelles Important for Ca Homeostasis

Mechanisms of Ca Signal Generation

Ca Entry and Exit

Ca‐Mediated Control of Enzyme Secretion

Ca‐Mediated Control of Fluid Secretion

Dangers of Ca Signaling

References

5 Physiology of Duct Cell Secretion

Introduction

Sequential Secretion by Acinar and Duct Cells

Regulation of Ductal Secretion

The Ca and cAMP Pathways Synergize to Activate Ductal Secretion

Ductal Secretion‐Associated Pancreatic Diseases

Acknowledgment

References

6 Pathophysiology of Experimental Pancreatitis

Introduction

Models of Acute Pancreatitis

Phases of Acute Pancreatitis

Early Intra‐Acinar Events in Acute Pancreatitis

Conclusion

References

7 Physiology and Pathophysiology of Function of Sphincter of Oddi

Introduction

Anatomy and Morphology

Innervation

Physiology

Motility of the Sphincter of Oddi

Sphincter of Oddi Motility Studies in Animals

Sphincter of Oddi Motility in Humans

Pathophysiology of the Sphincter of Oddi Dysfunction (SOD)

Conclusion

References

8 Neurohormonal and Hormonal Control of Pancreatic Secretion

Introduction

Stimulation of Pancreatic Secretion

Inhibition of Pancreatic Secretion

Feedback Regulation of Pancreatic Secretion

Conclusion

References

9 Regulation of Pancreatic Protein Synthesis and Growth

Introduction

Regulation of Protein Synthesis

Regulation of Pancreatic Growth

References

10 Fibrogenesis in the Pancreas: The Role of Stellate Cells

Introduction

Pancreatic Stellate Sells (PSC)

Acute Pancreatitis

Chronic Pancreatitis

Pancreatic Cancer

Conclusion

References

11 Fibrogenesis of the Pancreas: The Role of Macrophages

Introduction

Macrophages

Origin and Characteristics of Pancreatic Macrophages

Role of Macrophages in Chronic Pancreatitis‐Associated Fibrosis

Role of Macrophages in Pancreatic Cancer‐Associated Fibrosis

Conclusion

References

12 Insulo–Acinar Relationship

Introduction

Structural Relationships Between Pancreatic Islets and Exocrine Pancreas

Insulo‐Acinar Portal System

Regulation of Pancreatic Exocrine Secretion by Islet Hormones

Pancreatic Exocrine Function and Diabetes Mellitus

References

Section 3: Acute Pancreatitis

13 Epidemiology and Etiology of Alcohol‐Induced Pancreatitis

Introduction

Epidemiology

Pathogenesis

Summary

Acknowledgment

References

14 Epidemiology and Etiology of Acute Biliary Pancreatitis

Introduction

Etiology of Gallstone Pancreatitis

Epidemiology of Biliary Acute Pancreatitis

References

15 Genetic Factors in Acute Pancreatitis

Introduction

Genetic Susceptibility Factors

Multiple Genetic Defects and Susceptibility

Progression to Chronic Pancreatitis

Future Directions

References

16 The Role of the Intestine and Mesenteric Lymph in the Development of Systemic Inflammation and MODS in Severe Acute Pancreatitis

Introduction

Role of the Intestine and Mesenteric Lymph in Multiple Organ Dysfunction Syndrome

Role of the Intestine in Severe Acute Pancreatitis

Altered Gut–Lymph Composition in Acute Pancreatitis

Gut–Lymph Toxicity in Acute Pancreatitis

Translating the Gut–Lymph Concept to Clinical Treatments for Acute Pancreatitis

Conclusion

References

17 The Role of Neurogenic Inflammation in Pancreatitis

References

18 Molecular, Biochemical, and Metabolic Abnormalities in Acute Pancreatitis

Introduction

Molecular and Biochemical Abnormalities

Metabolic and Systemic Abnormalities

Electrocardiographic Abnormalities in Acute Pancreatitis

References

19 Histopathology of Acute Pancreatitis

Introduction

Definition

Histopathologic Patterns of Tissue Necrosis

Acute Pancreatitis with Type 1 Necrosis Pattern

Acute Pancreatitis with Type 2 Necrosis Pattern

Acute Pancreatitis with Type 3 Necrosis Pattern

Histopathology Related to Etiologic Factors and Pathophysiologic Mechanisms

Unsolved Questions

References

20 Clinical Classification Systems of Acute Pancreatitis

Introduction

Reasons for Classifying the Severity of Acute Pancreatitis

New Classification Systems

Validation and Comparison of Classification Systems

Future of Classification Systems

Conclusions

References

21 Clinical Assessment and Biochemical Markers to Objectify Severity and Prognosis

Introduction

Historical Perspectives: Approaches to Severity Assessment

Dynamics of Organ Failure

Multiparameter Scoring Systems

Laboratory Variables

Overview

References

22 Acute Pancreatitis Associated With Congenital Anomalies

Introduction

Pancreas Divisum

Anomalous Pancreaticobiliary Ductal Union

Choledochal Cyst/Choledochocele

Annular Pancreas

Ectopic Pancreatic Tissue

Enteric Duplication Cysts

Conclusions

References

23 Acute Pancreatitis in Children

Introduction

Incidence

Etiology

Pathophysiology

Investigations

Diagnosis

Imaging

Management

Outcomes

Acute Recurrent Pancreatitis

References

24 Acute Pancreatitis Associated With Metabolic Disorders, Infectious Diseases, or Drugs

Introduction

Metabolic Diseases

Infectious Diseases

Drug‐Related Diseases

References

25 Radiologic Diagnosis and Staging of Severe Acute Pancreatitis

Introduction

Classification of Acute Pancreatitis

Radiographic Diagnosis of Severe Acute Pancreatitis

Diagnosis of Local Complications of Acute Pancreatitis

Radiologic Staging of Severe Acute Pancreatitis

Limitations and Pitfalls of Radiological Diagnosis of Acute Pancreatitis

References

Clinical Course and Medical Treatment of Acute Pancreatitis

26 Conservative Therapy of Acute Pancreatitis

Introduction

Fluid Resuscitation

Enteral and Parenteral Nutrition

Conclusions

References

27 ICU Treatment of Severe Acute Pancreatitis

Introduction

Pre‐ICU Management

Special Considerations

Indications for ICU Admission

ICU Treatment of Severe Acute Pancreatitis

Early ICU Management (0–48 Hours from Onset of Pain)

Management of Metabolic Derangements

Late ICU Management (>48 Hours After the Onset of Pain)

Management of Infectious Risks

Transition Planning

References

28 Use of Antibiotics in Severe Acute Pancreatitis

Introduction

Infectious Complications

Spectrum of Bacteria

Rationales for Antibiotics inAcute Pancreatitis

Clinical Studies with Antibiotics

Indications for Antibiotic Treatment

Limitations of Antibiotic Treatment

References

Interventional and Surgical Management of Acute Pancreatitis

29 Indications for Interventional and Surgical Treatment of Necrotizing Pancreatitis

Introduction

Interventions for Pancreatic Necrosis: Historical Perspective

Indications and Timing of Intervention

Pancreatic Necrosis with Infection

Symptomatic Pancreatic Necrosis/Walled‐Off Necrosis

Surgical and Interventional Procedures

Surgical Debridement

Percutaneous Catheter Drainage

Direct Endoscopic Necrosectomy

References

30 Management of Infected Pancreatic Necroses

Pancreatic Necrosis

Mechanical Intervention

Transmural Drainage

Results of Endoscopic Therapy of Pancreatic Necrosis

Adverse Events of Endoscopic Therapy of Pancreatic Necrosis

References

31 Minimally Invasive Debridement and Lavage of Necrotizing Pancreatitis

Introduction

Technique

Techniques for Complex Collections

Early Complications

Postoperative Course

Outcome

References

32 Open Surgical Debridement in Necrotizing Pancreatitis

Introduction

General Technique of Open Surgical Debridement

Continuous Closed Lavage

Debridement and Open Packing/Staged Laparotomy

Debridement and Closed Packing

Open Cystogastrostomy for Walled‐Off Pancreatic Necrosis

Conclusion

References

33 Endoscopic Treatment of Biliary Acute Pancreatitis

Pathogenesis of Acute Biliary Pancreatitis

Diagnosis

Indication of Endoscopic Treatment

Techniques

Outcomes and Timing of Endoscopic Interventions

Cholecystectomy After Endoscopic Treatment

References

34 Strategies for the Treatment of Pancreatic Pseudocysts and Walled‐Off Necrosis After Acute Pancreatitis

Introduction

Indications for Endoscopic Treatment

Endoscopic Drainage vs. Necrosectomy: Choosing the Right Patient

Preventing Recurrence by Treating Disconnected Duct Syndrome

References

35 Strategies for the Treatment of Pancreatic Pseudocysts and Walled‐Off Necrosis After Acute Pancreatitis

Introduction

Definition of Pancreatic Pseudocyst and Walled‐Off Necrosis

Indications for Surgical Intervention

Timing of Interventions and Optimal Interventional Strategy for Walled’Off Necrosis

Surgical Intervention for PPC

References

36 Management of Fluid Collection in Acute Pancreatitis

Introduction

Definitions

Imaging of Acute Fluid Collections

Conservative Treatment of Pancreatitis and Pancreatic Fluid Collections

Conclusion

References

37 Management of Pancreatic Fistula in Acute Pancreatitis

Introduction

Pathogenesis and Classification

Diagnosis

Management of External Fistulas

Management of Internal Fistulas

Conclusions

References

Long-Term Outcome After Treatment of Acute Pancreatitis

38 Long‐Term Outcome After Acute Pancreatitis

Introduction

Risk Factors

Endocrine Pancreatic Dysfunction

Exocrine Dysfunction

Recurrent Pancreatitis and Chronic Pancreatitis

Quality of Life and Pain

Incisional Hernia

Pancreatic Cancer and Pancreas‐Related Death

Imaging Findings

Postpancreatitis Care and Follow‐Up Visits

Conclusions

References

Section 4: Chronic Pancreatitis

39 Molecular Understanding of Chronic Pancreatitis

Introduction