Pancreas Ecab

Pancreas - ECAB - E-Book

Recent Advances in Pancreas - ECAB - E-Book

Exocrine and Endocrine Pancreas: Clinical Implications - ECAB - E-Book

ECAB Diabetes and Exocrine pancreas - E-Book

The exocrine pancreatic function can be impaired by many different pancreatic disease as well as diseases that do not appear to be directly linked to the exocrine pancreas. Hormones stimulating exocrine function (e.g. CCK) might be reduced in diseases affecting the intestinal mucosa (IBD, celiac disease, AIDS) resulting in decreased exocrine secretion. The function of digestive enzymes might be affected by post-cibal asynchrony or by a decreased intraduodenal pH as in Zollinger-Ellison syndrome (ZE). An atrophy of pancreatic tissue might be caused by a lack of trophic factors, as may occur in IDDM, and pancreatic damage might occur due to drugs used for the treatment of other diseases. While some of these conditions appear to be rather rare and of minor clinical relevance, exocrine pancreatic involvement is very frequent in patients with diabetes mellitus. The diagnosis of the condition can be made by the exploration of the exocrine pancreatic secretion, which has been mainly used for the diagnosis of chronic pancreatitis and detection of pancreatic exocrine insufficiency of any etiology. Thus, diagnosis of the disease is classically based on the demonstration of either the morphological and/or the functional changes that typically develop over time in the course of the disease. Exocrine pancreatic function impairs progressively as chronic pancreatitis develops. Thus, exocrine pancreatic dysfunction refers to a mild, moderate or severe reduction of the exocrine pancreatic secretion. Finally, pancreatic function becomes insufficient to maintain a normal digestive process. Pancreatic exocrine insufficiency refers to the stage of maldigestion and malabsorption of nutrients as a consequence of a primarily and/or secondarily impaired exocrine pancreatic function. Pancreatic enzymes remain as the cornerstone for the effective treatment of various disease pathologies resulting in pancreatic exocrine insufficiency. The rigid criteria set forth by the FDA in the USA will ensure that effective pancreatic enzyme preparations will be available and allow the clinician to successfully treat maldigestion, malabsorption, vitamin deficiencies, protein-calorie malnutrition, and in selected patients, the abdominal pain associated with chronic pancreatitis and PEI. Pancreatic enzymes are particularly underused in chronic pancreatitis patients with PEI, post-gastric and intestinal surgery patients who develop an asynchrony of enzyme delivery to the intestine, and pancreatic cancer patients. Earlier use of potent pancreatic enzymes will enhance the quality of life for these patients. This clinical update has been designed to update the readers on the important aspects of the pancreatic exocrine insufficiency, resulting from different conditions and its impact on the patient. The book has stressed upon the various aspects of the condition like its etiology, diagnosis, evaluation, and management approach to the patient. Overall, the book presents to the readers an excellent compilation of clinically applicable literature sourced from the most acclaimed physicians across globe.

Pancreatic cancer remains a dismal disease with an incidence that is on the rise even in a low incidence region like India. In recent years, there have been significant advances in the understanding of pancreatic cancer largely due to strides in modern molecular biology, pathology and radiology. While molecular biology continues to provide an optimistic vision for future treatment approaches to this deadly disease, the recent identification of PanIN’s and resection margins in pancreatic cancer have important implications for current day-to-day practice. This book explains how better understanding of IPMN and its management has improved the scope of pancreatic tumors. It also explains what role do heat shock proteins perform in cancer. The book gives concise description on how a number of important advances have made pancreatic pathology an exciting and rapidly advancing field. There are chapters that explain how good endoscopic ultrasound is in detection of cancer pancreas and also talk about experimental studies on obstructive jaundice and biliary drainage. Neo-adjuvant strategies in operable pancreatic adenocarcinomas are also being explained in detail. It is sincerely hoped that this book will update the busy clinician as well as the academician on various aspects of current importance in management of pancreatic cancer. Understanding the role of IPMN in improving the scope of pancreatic tumors Describing performance of heat shock proteins in cancer Throwing some light on usefulness of endoscopic ultrasound in detecting cancer pancreas Getting an insight into neo-adjuvant strategies in operable pancreatic adenocarcinomas

Recent Advances in Pancreas - ECAB