Pancreatitis Medical and Surgical Management

Pancreatitis: medical and surgical management provides gastroenterologists and GI surgeons, both fully qualified and in training, with a focused, evidence-based approach to the most exciting developments in the diagnosis and clinical management of pancreatitis.

Focusing mainly on the rapidly changing and innovative medical and surgical strategies to manage the disease, new surgical procedures such as endoscopic biliary intervention and minimally invasive necrosectomy to exciting new medical therapies like Antiprotease, Lexipafant, probiotics and enzyme treatment are all discussed.

Full colour throughout, with over 250 colour illustrations and with reference to the latest clinical guidelines from the AGA, ACG and UEGW at all times, it is an essential consultation tool for all those managing patients with this increasingly common condition.

David B. Adams, M.D. is Professor and Chief of Gastrointestinal and Laparoscopic Surgery and Co-Director of the Digestive Disease Center at the Medical University of South Carolina, Charleston, South Carolina. He is the author of over 100 manuscripts and book chapters which deal with his academic and clinical research interests in chronic pancreatitis.

Peter B. Cotton, M.D. is a British Gastroenterologist best known for his advancement in digestive disease, pioneering and naming the ERCP procedure and creating the Digestive Disease Center at the Medical University of South Carolina where he is Professor of Medicine. He has been active in National and International organizations, and has given invited lectures and demonstrations in more than 50 countries His bibliography includes over 900 medical publications, including more than 300 original contributions in peer reviewed journals, and 10 books.

Nicholas J. Zyromski, M.D. is Associate Professor of Surgery at Indiana University. He served as an NIH research fellow at the Mayo Clinic in Rochester, Minnesota, and is currently the Indiana University HPB Surgery Fellowship Program Director. Dr. Zyromski’s principal clinical interest is in pancreatic disease; his basic and translational research interest focuses on the inflammatory response of acute pancreatitis as well as the influence of obesity and adipose tissue on pancreatic diseases — pancreatic cancer and acute pancreatitis.

John Windsor, M.D. holds a personal chair in surgery at the University of New Zealand, Auckland. He is Director of Surgical Research, Director of Surgical Research Network , Co-Director of Applied Surgery and Metabolism Laboratory and Surgical Centre for Outcomes Research and Evaluation, Principle Investigator Pancreas Research Group, and Associate Investigator Maurice Wilkins Centre of Biodiscovery. His primary research is in the pathophysiology and clinical management of acute and chronic pancreatitis. He is Associate Editor of the journal Pancreatology and the World Journal of Surgery.

List of contributors, vii

1 Epidemiology and genetics of chronic pancreatitis, 1

2A Pathobiology of the acinar cell in acute pancreatitis, 10

2B Locoregional pathophysiology in acute pancreatitis: pancreas and intestine, 19

2C Pathophysiology of systemic inflammatory response syndrome and multiorgan dysfunction syndrome in acute pancreatitis, 29

3 Diagnosis, prediction, and classification, 38

4 Medical treatment, 47

5 Nutritional treatment in acute pancreatitis, 55

6 Gallstone pancreatitis: diagnosis and treatment, 64

7 Treatment of local complications, 75

8 Treatment of systemic complications and organ failure, 85

9 Specific treatment for acute pancreatitis, 91

10 Sequelae of acute pancreatitis, 101

11 History of chronic pancreatitis, 113

12A Epidemiology and pathophysiology: epidemiology and risk factors, 118

12B Epidemiology and pathophysiology: genetic insights into pathogenesis, 126

12C Pancreatic stellate cells: what do they tell us about chronic pancreatitis?, 143

12D Autoimmune pancreatitis: an update, 152

12E Etiology and pathophysiology: tropical pancreatitis, 161

12F Mechanisms and pathways of pain in chronic pancreatitis, 169

13A Imaging of chronic pancreatitis, 179

13B Endoscopic ultrasonography in chronic pancreatitis, 188

14A Pancreatic enzyme replacement therapy (PERT), 195

14B Nutritional treatment: antioxidant treatment, 205

14C Pancreatogenic diabetes: etiology, implications, and management, 211

14D Nutrition without a pancreas: how does the gut do it?, 225

15A Endoscopic management of chronic pancreatitis, 233

15B Shocking and fragmenting pancreatic ductal stones, 245

15C Endoscopic management: celiac plexus blockade, 249

16A A brief history of modern surgery for chronic pancreatitis, 256

16B Surgery for chronic pancreatitis: indications and timing of surgery, 261

16C Chronic pancreatitis: surgical strategy in complicated diseases, 265

16D Surgery for chronic pancreatitis: pancreatic duct drainage procedures, 273

16E Surgical management: resection and drainage procedures, 279

16F The role of pancreatoduodenectomy in the management of chronic pancreatitis, 286

17A Total pancreatectomy and islet cell autotransplantation: patient selection, 295

17B Total pancreatectomy and islet cell autotransplantation: the science of islet cell preservation, from pancreas to liver, 299

17C Total pancreatectomy and islet cell autotransplantation: long-term assessment of graft function, 308

Index, 321

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