The Exocrine Pancreas

The secretions of the exocrine pancreas provide for digestion of a meal into components that are then available for processing and absorption by the intestinal epithelium. Without the exocrine pancreas, malabsorption and malnutrition result. This chapter describes the cellular participants responsible for the secretion of digestive enzymes and fluid that in combination provide a pancreatic secretion that accomplishes the digestive functions of the gland. Key cellular participants, the acinar cell and the duct cell, are responsible for digestive enzyme and fluid secretion, respectively, of the exocrine pancreas. This chapter describes the neurohumoral pathways that mediate the pancreatic response to a meal as well as details of the cellular mechanisms that are necessary for the organ responses, including protein synthesis and transport and ion transports, and the regulation of these responses by intracellular signaling systems. Examples of pancreatic diseases resulting from dysfunction in cellular mechanisms provide emphasis of the importance of the normal physiologic mechanisms.

In Collaboration with Pathologists in 7 Countries

The secretions of the exocrine pancreas provide for digestion of a meal into components that are then available for processing and absorption by the intestinal epithelium. Without the exocrine pancreas, malabsorption and malnutrition result. This chapter describes the cellular participants responsible for the secretion of digestive enzymes and fluid that in combination provide a pancreatic secretion that accomplishes the digestive functions of the gland. Key cellular participants, the acinar cell and the duct cell, are responsible for digestive enzyme and fluid secretion, respectively, of the exocrine pancreas. This chapter describes the neurohumoral pathways that mediate the pancreatic response to a meal as well as details of the cellular mechanisms that are necessary for the organ responses, including protein synthesis and transport and ion transports, and the regulation of these responses by intracellular signaling systems. Examples of pancreatic diseases resulting from dysfunction in cellular mechanisms provide emphasis of the importance of the normal physiologic mechanisms.

Clinical Pancreatology Since the book Clinical Pancreatology for Practising Gastroenterologists and Surgeons was first published sixteen years ago, the knowledge and clinical management of pancreatic diseases have developed markedly. Thanks to the development of the translational research and the from bench to bedside concept, much progress from the lab has been applied to clinical practice. In addition, several highly relevant clinical trials published over the last years have resulted in the update and optimisation of clinical guidelines. A new and validated classification of severity and complications of acute pancreatitis is firmly rooted in clinical practice and has been the basis for the development of minimally invasive approaches to pancreatic necrosis. The etiopathogenic knowledge of chronic pancreatitis and other pancreatopaties, like that associated with diabetes mellitus, has developed significantly. Especially important has been the development of the field of cystic pancreatic tumours, which has been reflected in the publication of several guidelines and consensus reports over the last few years. Most research efforts have focused on pancreatic cancer, which have led and will further lead to a significant increase in the therapeutic armamentarium against this devastating disease. Finally, many newly published studies have changed the concept, causes, clinical relevance, diagnosis and treatment of exocrine pancreatic insufficiency. This new edition of Clinical Pancreatology for Practising Gastroenterologists and Surgeons has enjoyed the collaboration of the world’s leading experts in each of the areas of clinical pancreatology with the aim of facilitating gastroenterologists, surgeons, oncologists, internists, nutritionists, diabetologists, paediatricians, radiologists, pathologists and other specialists in their decision making when facing patients with pancreatic diseases in their daily clinical practice. All in all, this book supplies an indispensable update of the relevant aspects of clinical pancreatology.

This innovative teaching atlas provides the reader with a practical approach to the diagnosis and management of the common and uncommon diseases that may involve the pancreatic gland. Its perspective is multidisciplinary, the authors being radiologists, surgeons, pathologists, and gastroenterologists who have worked together for the past 25 years. Very concise descriptions of clinical presentation, pathology, imaging, and management are provided for a great variety of pathologic conditions, and a wealth of illustrative material displays intraoperative appearances, gross specimens, histology, and radiological findings. Pancreatic surgery, including transplantation, is also discussed, and the final chapter presents a gallery of challenging and diverse cases. Specialists and residents in a range of specialties will find this atlas to be an invaluable aid, and it will also serve as an excellent reference for medical students.

Pathology of the Pancreas: A Practical Approach covers all the diagnostic entities in adult pancreatic pathology, providing extensive illustrations and tables to assist the pathologist at the time of diagnostic reporting of histological and cytological specimens. Potential pitfalls and mimics in pancreatic pathology are highlighted and illustrated, and guidance is provided regarding how to recognize and avoid them. Pathology of the Pancreas: A Practical Approach enables the pathologist to recognize the various pathological entities and provide the key information in their pathology reports, which is necessary for the individual patient’s further management. It is based on the most recent diagnostic algorithms, international consensus guidelines, and systems for disease classification, staging and grading. Clinical information is also included, where it is important for the multidisciplinary team management discussion. Pathology of the Pancreas: A Practical Approach is a bench book for everyday use beside the microscope and provides the diagnostic pathologist with a comprehensive, well-illustrated and extensively cross-referenced approach to pancreatic pathology.

Never before has a comprehensive history of the pancreas like History of the Pancreas been published. It not only is a historical review of the science of medicine, it is liberally interspersed with anecdotal vignettes of the researchers who have worked on this organ. Much of it, such as the discovery of the duct of Wirsüng, of the islets of Langerhans, of insulin, gastrin and their tumors, reads like the adverture, which it is. This book, divided into 14 chapters, is written in a narrative style and is easily readable, as glimpses of the investigators, those who failed as well as those who succeeded, adds both perspective and human interest. Each chapter is completely referenced, totaling over 1500 references. As a reference book for students, teachers, investigators, writers, its detailed hjistorical documentation is unique. From the pre-Christian era of Asia Minor, to Greece, Rome, Europe and America, to the explosive progress in Japan, the history is there. History of the Pancreas: Mysteries of a Hidden Organ fills a gap.