Pancreatic Disease: State of the Art and Future Aspects of Research

275 Pages·1999·6.108 MB·English

by  Prof. Dr. Paul G. Lankisch, Prof. Dr. Eugene P. DiMagno (auth.)

Pancreatic Disease
Springer
Berlin
Heidelberg
New York
Barcelona
Hong Kong
London
Milan
Paris
Singapore
Tokyo
P. G. and E. P.
LANKISCH DIMAGNO
Pancreatic Disease
State of the Art and
Future Aspects of Research
With 40 Figures and 47 Tables
, Springer
Prof. Dr. PAUL G. LANKrSCH
Medizinische Klinik
Stadtisches Klinikum Liineburg
BogelstraGe 1
D-21339 Liineburg
Prof. Dr. EUGENE P. DrMAGNO
Mayo Foundation
Gastroenterology Research Unit
200 First Street, SW
Rochester, Minnesota 55905
USA
ISBN-13: 978-3-540-65357-8 e-ISBN-13: 978-3-642-60068-5
DOl: 10.l007/978-3-642-60068-5
Cataloging-in-Publication Data applied for
Die Deutsche Bibliothek - CIP-Einheitsaufnahme
Lankisch, Paul, G.: Pancreatic disease: state of the art and future aspects of research; with 47 tables 1
P.G. Lankisch and E.P. DiMagno. - Berlin; Heidelberg; New York; Barcelona; Hong Kong; London;
Mailand; Paris; Singapore; Tokyo: Springer, 1998
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Preface
In the past several years much progress has been made in understanding the
basic mechanisms of pancreatic physiology and the pathogenesis, diagnosis,
and treatment of pancreatic disease.
A symposium took place in Munich on 18-19 September 1998 that aimed
at summarizing current knowledge of the exocrine pancreas and giving di
rection to future research. It targeted all practitioners and scientists working
in the field of exocrine pancreatic disease. The symposium was also designed
to stimulate young persons embarking on a career in this area.
It was an exciting meeting for all of us. We wish to extend our thanks to
all participants for their prompt submission of manuscripts and to Springer
Verlag for speedy publication, providing us with an up-to-date volume on
pancreatic research.
We would also like to thank G. Beyendorff-Hajda and W. Glockner, as well
as D. Kriiger, representatives of Knoll Deutschland GmbH, for their organiza
tional assistance and Knoll itself for its generous sponsorship, which enabled
colleagues from other countries to participate and made publication of the
symposium possible.
P. G. LANKrSCH
E. P. DrMAGNo
Table of Contents
Part I Acute Pancreatitis
Acute Pancreatitis: Mechanisms of Cell Injury - Genetics
D. C. WHITCOMB .................................. 3
2 Events Inside the Pancreatic Acinar Cell in Acute Pancreatitis:
Role of Secretory Blockade, Calcium Release and Dehydration
for the Initiation of Trypsinogen Activation and Autodigestion
C. NIEDERAU and R. LUTHEN ........................ . 14
3 Immunologic Mechanisms in Acute Pancreatitis
J. SCHOLMERICH ................................. . 24
4 Mechanisms in Cellular Injury
CH. HANCK and M. V. SINGER ........................ . 36
5 Acute Pancreatitis: Bacterial Translocation
and Pancreatic Infections
ST. W. SCHMID, W. UHL, and M. W. BUCHLER 39
6 Staging and Early Nasolateral Feeding in Acute Pancreatitis
C.W. IMRIE ..................................... . 55
7 Acute Pancreatitis: Medical and Endoscopic Treatment
C. LOSER and U. R. FOLSCH ......................... . 66
8 Surgical Treatment of Acute Pancreatitis
H.G. BEGER, B. RAU, J. MAYER, and R. ISENMANN 78
Part II Chronic Pancreatitis
9 Chronic Pancreatitis: Do Different Etiologies
(Alcohol, Obstruction) Invoke Different Mechanisms?
J. MOSSNER ..................................... . 93
VIII Table of Contents
10 Exocrine Pancreatic Secretion, Pain, and Malabsorption
G. H. ELTA ....................................... 102
11 Intestinal Transit of Chyme and its Regulatory Role:
Clinical Implications
P. LAYER and J. KELLER ............................. 112
12 Treatment of Exocrine Pancreatic Insufficiency
in Chronic Pancreatitis
M.J. BRUNO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
13 Mechanisms of Fibrosis and Potential Antifibrotic Agents
A. MENKE, R. VOGELMANN, M. BACHEM, and G. ADLER 132
14 Mechanisms of Pain and its Medical Management,
Including Neurolytic Treatments
L. GULLO. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
15 Endoscopic Treatment of Pain and Complications
of Chronic Pancreatitis
R. JAKOBS, D. APEL, and J.E RIEMANN. . . . . . . . . . . . . . . . . . 146
16 Surgical Treatment of Chronic Pancreatitis
H. G. BEGER, M. SIECH, and W. SCHLOSSER 155
Part III Cystic Fibrosis
17 Genetics and Molecular Pathology of Cystic Fibrosis
B. TUMMLER ..................................... 167
18 Treatment of Gastrointestinal Manifestations in Cystic Fibrosis
M. STERN. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
19 Is Idiopathic Chronic Pancreatitis Cystic Fibrosis?
J.A. COHN ....................................... 193
Part IV Pancreatic Cancer
20 Growth Factors and Transcription Factors in Pancreatic Cancer
H. FRIESS, Z. W. ZHU, L. WANG and M. W. BUCHLER . . . . . . . . 205
21 Biological Approaches to the Therapy of Pancreatic Cancer
M. A. TEMPERa. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222
Table of Contents IX
22 Pancreatic Cancer: Preclinical Development of an Experimental
Treatment Strategy Using Retinoids and Interferon-alpha
ST. ROSEWICZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230
23 Aspects of Radical Surgery for Exocrine Cancer
of the Pancreatic Head
A. ANDREN-SANDBERG, D. HOEM, and H. GISSLASON 238
Part V Epidemiology
24 Lessons Learned about Pancreatitis and Pancreatic Cancer from
Epidemiological Studies
A. B. LOWENFELS, P. MAISONNEUVE and P. G. LANKISCH ..... 253
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 263
List of Contributors
ADLER, GUIDO, Prof. Dr. med. Hospital of Bern, Inselspital,
Department of Internal Medicine I, CH-3010 Bern, Switzerland
University of Ulm, Robert-Koch
Strasse 8, D-89070 Ulm, Germany COHN, JONATHAN A., MD
Departments of Medicine and Cell
ANDREN-SANDBERG, AKE, MD PhD Biology, Duke University Medical
Department of Surgery, Haukeland Center, Durham, NC 27710, USA
University Hospital, N-S021 Bergen,
Norway ELTA, GRACE H., MD
University of Michigan Medical
APEL, DARIUS, Dr. med. Center, 3912 Taubman Center, Box
Department of Gastroenterology, 0362, Ann Arbor, MI 48109, USA
Klinikum Ludwigshafen gGmbH,
Bremserstrasse 79, FOLSCH, U.R., Prof. Dr. med.
D-67063 Ludwigshafen, Germany I. Medizinische Universitatsklinik,
Christian-Albrechts-Universitat Kiel,
BACHEM, MAX, MD Schittenhelmstrasse 12,
Department of Clinical Chemistry, D-241OS Kiel, Germany
University of Ulm, Robert-Koch
Strasse 8, D-89070 Ulm, Germany FRIESS, HELMUT, MD
Department of Visceral and Trans
BEGER, HANS G., MD, FACS plantation Surgery, University Bern,
Head of the Department of General Inselspital, CH-3010 Bern,
Surgery, University of Ulm, Switzerland
Steinhovelstrasse 9, D-8907S Ulm,
Germany GISSLASON, HrORTUR
Department of Surgery, Haukeland
BRUNO, MARCO J. University Hospital, N-S021 Bergen,
Academic Medical Center, Division Norway
of Gastroenterology and Hepatology,
Meibergdreef 9, 1l0S AZ Amster GULLO, LUCIO, Prof.
dam, The Netherlands Department of Internal Medicine
and Gastroenterology, University
BUCHLER, M.W., PROF. DR. of Bologna, S. Orsola Hospital,
Department of Visceral and Trans Via Massarenti, 9,
plantation Surgery, University I-40l38 Bologna, Italy
XII List of Contributors
HANCK, CHRISTOPH, MD LOWENFELS, ALBERT B., MD
Dept. of Internal Medicine IV Department of Surgery, New York
(Gastroenterology), University Medical College, Valhalla, NY, 10595,
Hospital of Heidelberg at Mannheim, USA
Theodor Kutzer Ufer 1,
D-68167 Mannheim, Germany Lii'THEN, REINHARD
Department of Medicine, Heinrich
Heine-University Dusseldorf,
HOEM, DAG
Moorenstrasse 5,
Department of Surgery, Haukeland
D-40225 Dusseldorf, Germany
University Hospital, N-5021 Bergen,
Norway
MAISONNEUVE, PATRICK
Clinical Epidemiology Program,
IMRIE, C.W., Prof. European Institute of Oncology,
Glasgow Royal Infirmary, Milan, Italy
Lister Department of Surgery,
16 Alexandra Parade, MAYER, JENS, MD
Glasgow G31 2ER, Great Britain Department of General Surgery,
University of Ulm, Steinhovel
strasse 9, D-89075 Ulm, Germany
ISENMANN, RAINER
Department of General Surgery,
University of Ulm, Steinhovel MENKE, ANDRE
strasse 9, D-89075 Ulm, Germany Department of Internal Medicine I,
University of Ulm, Robert-Koch
Strasse 8, D-89070 Ulm, Germany
JAKOBS, RALF, Dr. med.
Department of Gastroenterology,
MOSSNER, JOACHIM, Prof. Dr. med.
Klinikum Ludwigshafen gGmbH,
Medizinische Klinik und Poliklinik
Bremserstrasse 79,
II, University of Leipzig, Philipp
D-67063 Ludwigshafen, Germany
Rosenthal-Strasse 27,
D-04103 Leipzig, Germany
KELLER, JUTTA, MD
Department of Internal Medicine, NIEDERAU, CLAUS, MD
Israelitic Hospital, Orchideenstieg st. Josef-Hospital, Academic Teach
14, D-22297 Hamburg, Germany ing Hospital, Department of Internal
Medicine, Miilheimerstrasse 83,
D-46045 Oberhausen, Germany
LAYER, PETER, MD, Prof. of Medicine
Head of Department of Internal
RAU, BETTINA
Medicine, Israelitic Hospital,
Department of General Surgery,
Orchideenstieg 14,
University of Ulm, SteinhOvel
D-22297 Hamburg, Germany
strasse 9, D-89075 Ulm, Germany
LOSER, CHRISTIAN, Prof. Dr. med. RIEMANN, J.F., Prof. Dr. med.
I. Medizinische Universitatsklinik, Medizinische Klinik C,
Christian -Albrechts-Universitat Kiel, Klinikum Ludwigshafen gGmbH,
Schittenhelmstrasse 12, Bremserstrasse 79,
D-24105 Kiel, Germany D-67063 Ludwigshafen, Germany