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The Pancreas

Downloaded from https://onlinelibrary.wiley.com/doi/ by Universität Bern, Wiley Online Library on [22/08/2023]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

The Pancreas

An Integrated Textbook of Basic Science, Medicine, and Surgery

Fourth Edition

Edited by

Hans G. Beger, MD, FACS (Hon.), JSS (Hon.), CSS (Hon.)

Founding Editor, Professor Emeritus of Surgery, University of Ulm, Ulm, Germany.

Markus W. Büchler, MD FACS (Hon.), FRCS (Hon.), FASA (Hon.)

Professor of Surgery, University of Heidelberg, Heidelberg, Germany.

Ralph H. Hruban, MD FACS (Hon.), FRCS (Hon.), FASA (Hon.)

Baxley Professor and Director, Department of Pathology, and Director of the Sol Goldman Pancreatic Research Center, Johns Hopkins University School of Medicine, Baltimore, USA.

Julia Mayerle, MD

Professor of Internal Medicine, Gastroenterology and Hepatology, Chair Department of Medicine II, LMU Klinikum, Ludwig-MaximiliansUniversity, Munich, Germany.

John P. Neoptolemos, MA, MB, BCHIR, MD FRCS, FMEDSCI, MAE

Professor of Surgery, Department of Surgery, University of Heidelberg, Heidelberg, Germany.

Tooru Shimosegawa, MD, PhD

Professor Emeritus Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.

Andrew L. Warshaw, MD, FACS, FRCSEd (Hon.)

W. Gerald Austen Distinguished Professor of Surgery, Harvard Medical School, and Surgeon-in-Chief Emeritus, Massachusetts General Hospital, Boston, USA.

David C. Whitcomb, MD, PhD

Professor of Medicine, Cell Biology & Physiology, Human Genetics, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh and UPMC, Pennsylvania, USA.

Yupei Zhao, MD, FICS (Hon.), FACS (Hon.), FRCS (Engl) (Hon.), FCSHK (Hon.)

Professor of Surgery, Department of General Surgery, Peking Union Medical College Hospital, Beijing, P.R. China.

Coordinating Editor

Christiane Groß

German Foundation for the Fight Against Pancreatic Cancer, c/o University of Ulm, Ulm, Germany

This edition first published 2023

John Wiley & Sons Ltd (1e 1998, 2e 2008, 3e 2018)

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions.

The right of Hans G. Beger, Markus W. Büchler, Ralph H. Hruban, Julia Mayerle, John P. Neoptolemos, Tooru Shimosegawa, Andrew L. Warshaw, David C. Whitcomb, and Yupei Zhao to be identified as the editorial material in this work has been asserted in accordance with law.

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John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, USA John Wiley & Sons Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

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Limit of Liability/Disclaimer of Warranty

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Library of Congress Cataloging- in- Publication Data

Names: Beger, H. G. (Hans G.), editor. Title: The pancreas : an integrated textbook of basic science, medicine,

and surgery / edited by Hans G. Beger, Markus W. Büchler, Ralph H. Hruban, Julia Mayerle, John P. Neoptolemos, Tooru Shimosegawa, Andrew L.

Warshaw, David C. Whitcomb, Yupei Zhao, Christiane Gross. Other titles: Pancreas (Beger) Description: Fourth edition. | Hoboken, NJ : Wiley, 2023. | Includes

bibliographical references and index. Identifiers: LCCN 2022047652 (print) | LCCN 2022047653 (ebook) | ISBN

9781119875970 (cloth) | ISBN 9781119875987 (adobe pdf) | ISBN

9781119875994 (epub) Subjects: MESH: Pancreatic Diseases–physiopathology | Pancreatic

616.3/7–dc23/eng/20221209 LC record available at https://lccn.loc.gov/2022047652 LC ebook record available at https://lccn.loc.gov/2022047653

Cover Design: Wiley Cover Image: Courtesy of Carolyn Hruban

Set in 10/12pt WarnockPro by Straive, Pondicherry, India

Preface

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The fourth edition of The Pancreas presents the most comprehensive and latest knowledge about the genetic and molecular biological basis of embryology, anatomy, physiology, pathophysiology, and pathology for all disorders of the pancreas. Compared to the first edition, published in 1998, the fourth edition contains three newly addressed diseases of the pancreas: autoimmune pancreatitis, benign and premalignant cystic neoplasms, and neuroendocrine tumors. The understanding of the functions and dysfunctions of the exocrine and endocrine pancreas is derived from increasingly profound molecular biological data on the actions of compounds in subcellular compartments and intracellular transcription pathways. In the respective chapters, the presentation of the inflammatory (acute or chronic) and oncological diseases (benign, premalignant, or advanced cancer) is based on molecular biological understanding of pathomorphological processes and clinical phenomena. In clinical pancreatology, new and improved technical devices enable the gastroenterologist and the gastrointestinal surgeon to identify lesions by highresolution imaging techniques, imaging of metabolic processes, and intrapancreatic ductal morphologic processes. The molecular profiling of pancreatic ductal adenocarcinoma has provided a deeper understanding of the genomic alterations that drive pancreatic ductal adenocarcinoma, including driver genes, actionable mutations, copy number alterations, patterns of genomic aberrations, structural variations, and mutational signatures. These findings have transformed our biological genomic understanding, but are still of limited clinical utility. Significant progress has been made in understanding the molecular pathogenesis of pancreatic cancer and identification of various molecular subtypes. However, this improved understanding has unfortunately not yet led to relevant progress for the patient’s cure, although survival gain after radical cancer resection in addition with neoadjuvant chemotherapy is significant for selected groups of patients.

The synergistic interaction of basic scientists, patholo-

gists, gastroenterologists, and gastrointestinal tract

surgeons in the field of investigative and clinical pancreatology has led to a better understanding of pancreatic diseases through combining the knowledge of each to achieve the best management. Most importantly, the decision- making for patients with an option to be successfully treated for pancreatic disease is increasingly based on high- evidence data from clinical trials on treatment. New technical devices— endoscopic visualization of cellular abnormalities, laparoscopic minimally invasive surgical approaches, and robotic surgery— have led to significant clinical improvement. The establishment of local, parenchyma- sparing surgical approaches for the increasing number of benign tumors, cystic neoplasms, and neuroendocrine tumors have significantly improved the patient’s outcome compared to classical pancreatic resections.

The goal of this fourth edition is to provide the clinician with the most current evidence- based synthesis of understanding of pancreatic diseases, functional assessment, diagnostic and technical devices, treatment options, and outcome results. All chapters are written by leading international experts on the topic. A major part of this edition has been contributed by international basic scientists, who provide an understanding of the molecular basis of pancreatic functions and dysfunctions. The editors acknowledge and are deeply indebted to all authors who have contributed to this edition. Their diligent efforts have provided state- of- the- art knowledge, particularly in regard to decision- making based on clinical evidence.

Hans G. Beger, Ulm

Markus W. Büchler, Heidelberg

Ralph H. Hruban, Baltimore

Julia Mayerle, München

John P. Neoptolemos, Heidelberg

Tooru Shimosegawa, Sendai Andrew L. Warshaw, Boston

David C. Whitcomb, Pittsburgh

Yupei Zhao, Beijing

https://t.me/medicina_free

Contents

About theCompanion Website xvii

Section 1 Anatomy of the Pancreas 1

1 Development of the Pancreas andRelated Structures 3

Brian Lewis and Junhao Mao

2 Anatomy, Histology, andFine Structure ofthe Pancreas

Daniel S. Longnecker and Elizabeth D. Thompson

3 Congenital andInherited Anomalies ofthe Pancreas

Heiko Witt and Martin Zenker

Section 2

4 Physiology ofAcinar Cell Secretion 35

Ole H. Petersen

5 Physiology ofDuct Cell Secretion

Wei- Yin Lin, Paramita Sarkar, and Shmuel Muallem

6 Physiology andPathophysiology ofFunction ofSphincter ofOddi

Savio George Barreto and James Toouli

7 Neurohormonal andHormonal Control ofPancreatic Secretion

Chung Owyang and Matthew J. DiMagno

8 Regulation ofPancreatic Protein Synthesis andGrowth

Maria Dolors Sans and John A. Williams

Physiology and Pathophysiology of Pancreatic Functions 33

9 Fibrogenesis inthe Pancreas: The Role ofPancreatic Stellate Cells

Minoti V. Apte, Romano C. Pirola, and Jeremy S. Wilson

10 Pancreatic Endocrine–Exocrine Relationship

Kenichiro Furuyama and Yoshiya Kawaguchi

Section 3 Acute Pancreatitis 105

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11 Epidemiology andEtiology ofAlcohol- Induced Pancreatitis 107

Jeremy S. Wilson, Romano C. Pirola, and Minoti V. Apte

Contents vii

12 Epidemiology andEtiology ofBiliary Acute Pancreatitis

Ippei Ikoma, Ko Tomishima, and Hiroyuki Isayama

13 Genetic Factors inAcute Pancreatitis

Mitchell L. Ramsey and Georgios I. Papachristou

14 The Role ofthe Intestine andMesenteric Lymph inthe Development ofOrgan Dysfunction inSevere Acute

Pancreatitis

Alistair B.J. Escott, Anthony R.J. Phillips, and John A. Windsor

15 The Role ofNeurogenic Inflammation inPancreatitis

Metrah Mohammad Nader and Jami L. Saloman

16 Molecular, Biochemical, andMetabolic Abnormalities ofAcute Pancreatitis

Ujjwal M. Mahajan, F. Ulrich Weiss, Markus M. Lerch, and Julia Mayerle

17 Histopathology ofAcute Pancreatitis

Günter Klöppel

18 Severity Classification ofAcute Pancreatitis

John A. Windsor

19 Clinical Assessment andBiochemical Markers toObjectify Severity andPrognosis

Bettina M. Rau and Claus Schäfer

138

128

164

170

119

146

155

176

20 Acute Pancreatitis Associated withCongenital Anomalies

Charlotte S. Austin, Christopher R. Schlieve, Andrew L. Warshaw, and Tracy C. Grikscheit

21 Acute Pancreatitis inChildren

Mark E. Lowe and Véronique D. Morinville

22 Acute Pancreatitis Associated withMetabolic, Infections andDrug- Related Diseases

Ali A. Aghdassi, Mats L. Wiese, Quang Trung Tran, andMarkus M. Lerch

23 Radiologic Diagnosis andStaging ofSevere Acute Pancreatitis

Yoshihisa Tsuji

24 Conservative Therapy ofAcute Pancreatitis: Volume Substitution andEnteral andParenteral Nutrition

Steven M. Hadley, Jr. and Timothy B. Gardner

25 ICU Treatment of Severe Acute Pancreatitis

Scott R. Gunn and David C. Whitcomb

26 Clinical Course andMedical Treatment ofAcute Pancreatitis— Use ofAntibiotics inSevere Acute Pancreatitis:

Indications andLimitations

Rainer Isenmann and Mathias Wittau

191

230

238

185

199

208

222

Contents

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viii

27 Indications forInterventional andSurgical Treatment ofNecrotizing Pancreatitis 244

Lily V. Saadat and Thomas E. Clancy

28 Management ofInfected Necrosis: Step- Up Approach

Hester C. Timmerhuis, Marc G. Besselink, and Hjalmar C. van Santvoort

29 Management ofInfected Pancreatic Necroses: An Endoscopic Approach

Todd H. Baron

30 Minimally Invasive Debridement andLavage ofNecrotizing Pancreatitis

Kulbir Mann and Michael G.T. Raraty

31 Open Surgical Debridement ofNecrotizing Pancreatitis: Late Postoperative Morbidity andOutcome

Dongya Huang, Zipeng Lu, and Yi Miao

32 Endoscopic Treatment ofAcute Biliary Pancreatitis

Ichiro Yasuda, Tsuyoshi Mukai, and Toru Ito

33 Strategies forthe Treatment ofPancreatic Pseudocysts andWalled- Off Necrosis After Acute Pancreatitis:

Interventional Endoscopic Approaches

Georg Beyer and Julia Mayerle

34 Pseudocysts andWalled- Off Necrosis After Acute Pancreatitis: Surgical Approach

Naohiro Sata, Masaru Koizumi, and Alan Kawarai Lefor

35 Management ofFluid Collection inAcute Pancreatitis

Georg Beyer, Simon Sirtl, Christoph Ammer- Herrmenau, and Albrecht Neesse

284

254

260

266

278

288

294

271

36 Management ofPancreatic Fistula inAcute Pancreatitis

Marta Sandini, Thilo Hackert, and Markus W. Büchler

37 Long- Term Outcome After Acute Pancreatitis

Christin Tjaden and Thilo Hackert

Section 4

38 Definition andClassification ofChronic Pancreatitis 317

David C. Whitcomb

39 Molecular Understanding ofChronic Pancreatitis

Bomi Lee, Monique T. Barakat, and Sohail Z. Husain

40 Natural History ofRecurrent Acute andChronic Pancreatitis

Rohit Das, Jorge D. Machicado, and Dhiraj Yadav

41 Pediatric Recurrent Acute andChronic Pancreatitis: Role ofPancreas Divisum

Jiri Snajdauf, Michal Rygl, Barbora Kucerova, and Natalia Newland

42 Clinical andLaboratory Diagnosis ofChronic Pancreatitis

Georg Beyer, Markus M. Lerch, and Julia Mayerle

Chronic Pancreatitis 315

306

300

326

334

349

344

43 Abdominal Imaging forthe Diagnosis ofChronic Pancreatitis 357

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Atsushi Irisawa and Akira Yamamiya

Contents ix

44 Endoscopic Ultrasound forDiagnosis ofChronic Pancreatitis Versus PancreaticCancer

J. Enrique Domínguez- Muñoz, Julio Iglesias- García, José Lariño- Noia, and Daniel de la Iglesia- García

45 Hereditary Pancreatitis andComplex Genetic Causes

Celeste Shelton Ohlsen and David C. Whitcomb

46 Epidemiology andPathophysiology ofTropical Chronic Pancreatitis

Shailesh V. Shrikhande and Savio G. Barreto

47 CFTR- Associated Pancreatic Disease

Chee Y. Ooi and Aliye Uc

48 Alcohol andSmoking inChronic Pancreatitis

Atsushi Masamune, Kazuhiro Kikuta, and Kiyoshi Kume

49 Idiopathic andRare Causes ofChronic Pancreatitis

Morihisa Hirota and Tooru Shimosegawa

50 Early Chronic Pancreatitis

Kazuhiro Kikuta and Atsushi Masamune

51 Chronic Pancreatitis withInflammatory Mass inthe Pancreatic Head

Ulrich F. Wellner, Kim C. Honselmann, and Tobias Keck

412

390

396

375

383

404

418

366

52 Structural Complications: Strictures, Stones, Pseudocysts, andVascular Complications

Xiaodong Tian, Xiaochao Guo, and Yinmo Yang

53 Nutritional Evaluation andSupport: AnOverview

Sinead N. Duggan and Stephen J. O’Keefe

54 Exocrine Pancreatic Insufficiency

Chris E. Forsmark

55 Bone Disease inChronic Pancreatitis

Sinead N. Duggan

56 Diabetes fromExocrine Pancreatic Disease

Nao Fujimori, Tetsuhide Ito, and Yoshihiro Ogawa

57 Oxidative Stress andAntioxidants inChronic Pancreatitis

Soumya Jagannath Mahapatra and Pramod Kumar Garg

58 Pain Mechanisms inChronic Pancreatitis

Pierluigi Di Sebastiano, Fabio Francesco di Mola, Tommaso Grottola, and Rossana Percario

59 Pain Management inChronic Pancreatitis

Louise Kuhlmann, Søren S. Olesen, and Asbjørn M. Drewes

436

442

460

467

430

445

451

424

Contents

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60 Adjunctive Therapy inChronic Pancreatitis 474

Anna Evans Phillips

61 Pancreatic Cancer Risks inChronic Pancreatitis

Patrick Maisonneuve and Albert B. Lowenfels

62 Evidence ofEndoscopic andInterventional Treatment ofChronic Pancreatitis andPseudocysts

Jörg Schirra, Simon Sirtl MD, Markus M. Lerch, and Julia Mayerle

63 Major Pancreatic Resection forChronic Pancreatitis: Indication, Goals, and Limitations

Faik G. Uzunoglu and Jakob R. Izbicki

64 Pancreatic Drainage Procedures: Techniques andResults

Ulrich F. Wellner, Dirk Bausch, and Tobias Keck

65 Duodenum- Preserving Pancreatic Head Resections forChronic Pancreatitis: Techniques andResults

Hans G. Beger, Bertram Poch, Yang Yinmo, and Waldemar Uhl

66 Total Pancreatectomy withIslet Autotransplant

Greg Beilman, Zachary Bergman, and Melena Bellin

67 Minimally Invasive Surgical Management ofChronic Pancreatitis

Gilbert Z. Murimwa, Herbert J. Zeh III, and Matthew R. Porembka

Section 5

Autoimmune Pancreatitis 533

480

486

496

501

515

523

506

68 Epidemiology ofAutoimmune Pancreatitis 535

Terumi Kamisawa

69 Molecular Immunology andPathogenesis ofAutoimmune Pancreatitis

Yoh Zen

70 Clinical Manifestation ofType 1 Autoimmune Pancreatitis

Tooru Shimosegawa

71 Clinical Manifestation ofType 2 Autoimmune Pancreatitis

Nicolò de Pretis and Luca Frulloni

72 Clinical Diagnostic Criteria forAutoimmune Pancreatitis

Tooru Shimosegawa

73 Laboratory Diagnosis ofAutoimmune Pancreatitis

J- Matthias Löhr and Miroslav Vujasinovic

74 What is theEvidence Measuring Immune Markers

Shigeyuki Kawa, Takayuki Watanabe, and Norihiro Ashihara

75 Autoimmune Pancreatitis andIgG4- Related Disease

Kazuichi Okazaki, Tsukasa Ikeura, and Kazushige Uchida

573

546

554

561

568

579

540

76 Imaging Diagnosis ofAutoimmune Pancreatitis

Kazuichi Okazaki, Makoto Takaoka, Tsukasa Ikeura, and Kazushige Uchida

595

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