Diagnostic Procedures in Pancreatic Disease

ISBN-13: 9783642644641 / Angielski / Miękka / 2011 / 446 str.

Malfertheiner P. Malfertheiner; J. E. Dominguez-Munoz; H. -U Schulz

Opis

"A decade of diagnostic efforts in pancreatic diseases (1985-1995)" The diagnostic access to the pancreas was revolutionized two decades ago by the advent of endoscopic retrograde pancreatography, ultrasound, and com puted tomography. The "hidden" organ was made visible by these diagnostic milestones. In a process of slow but continuous evolution, these imaging tech niques have been further refined and complemented by nuclear magnetic reso nance imaging, and together they provide the standards on which therapeutic decisions depend. Progress has also been made in the functional assessment of the pancreas in various conditions of disease such as acute pancreatitis, chronic pancreatitis, and cancer. New developments in molecular biology also promise more significant achievements in the near future. Ten years ago we gathered a panel of international specialists dedicated to the study and management of pancreatic diseases and invited them to share their experiences with the available diagnostic methods. We have now repeated this process in order to review the past decade of progress in diagnostic procedures in pancreatic disease and to update the current state of expertise and stimulate further developments. The concept of the meeting, held in Magdeburg in December 1995, was to individually analyze the different diagnostic procedures and their specific use in the different disease conditions. The rationale for the interpretation of diagnostic findings is derived from the understanding of basic physiological and pathophysiological events and the resultant morphological alterations."

Spis treści

Classification of Pancreatitis: Problems and Prospects.- A. Acute Pancreatitis.- Morphology of Acute Pancreatitis in Relation to Etiology and Pathogenesis.- Clinical Presentation and Course of Acute Pancreatitis.- I. Imaging Procedures.- Ultrasound in the Diagnosis and Grading of Acute Pancreatitis.- Computed Tomography in Acute Pancreatitis: Diagnosis, Staging, and Detection of Complications.- Diagnosis of Infected Pancreatic Necrosis.- Endoscopic Retrograde Cholangiopancreatography in Acute Pancreatitis: Indications and Limitations.- II. Functional Methods.- Appropriate Use of Serum Pancreatic Enzymes for the Diagnosis of Acute Pancreatitis.- Identification of the Etiological Factor in Acute Pancreatitis.- Exocrine Pancreatic Function During and Following Acute Pancreatitis.- Endocrine Pancreatic Function During and Following Acute Pancreatitis.- III. Prognostic Evaluation.- Pathophysiological Determinants of Severity of Acute Pancreatitis.- Clinical Value of Multifactorial Classification in the Prognostic Evaluation of Acute Pancreatitis.- Biochemical Markers in the Early Prognostic Evaluation of Acute Pancreatitis.- Prognostic Evaluation of Acute Pancreatitis: When- and How-Consequences for Clinical Management.- Diagnostic and Prognostic Evaluation of Graft Pancreatitis.- IV. Guidelines.- Acute Pancreatitis: Diagnostic Guidelines for General Practitioners, Clinicians in Community Hospitals and in Specialized Centers.- B. Chronic Pancreatitis.- I. Chronic Pancreatitis: Clinical Features.- Pathomorphological Feature of Chronic Pancreatitis.- Pathophysiological Events in Chronic Pancreatitis: The Current Concept.- Clinical Presentation and Course of Chronic Pancreatitis.- Painless Versus Painful Chronic Pancreatitis.- II. Imaging Procedures.- Role of Ultrasonography in the Diagnosis, Staging and Detection of Complications of Chronic Pancreatitis.- Diagnosis and Staging of Chronic Pancreatitis by Computed Tomography.- Diagnosis and Staging of Chronic Pancreatitis by Endoscopic Retrograde Cholangiopancreatography.- Radiologic Imaging of Chronic Pancreatitis.- Role of Pancreatic Duct Drainage for Evaluation of Pancreatic Pain.- What Does the Surgeon Need in the Preoperative Evaluation of Chronic Pancreatitis?.- III. Function Tests.- Neuroendocrine Abnormalities of Upper Gut Function in Chronic Pancreatitis: Lessons for Physiology and Pathophysiology.- Direct Pancreatic Function Tests in the Diagnosis and Staging of Chronic Pancreatitis.- Oral Pancreatic Function Tests in the Diagnosis and Staging of Chronic Pancreatitis.- Present and Future of Breath Tests in the Diagnosis of Pancreatic Insufficiency.- Value of Serum Pancreatic Enzymes in the Diagnosis of Chronic Pancreatitis.- New Fecal Tests in the Diagnosis of Exocrine Pancreatic Insufficiency.- Extracellular Matrix in Pancreatic Diseases.- Endocrine Pancreatic Function in the Diagnosis and Staging of Chronic Pancreatitis.- IV. Chronic Pancreatitis: Guidelines.- Diagnostic Standards for Chronic Pancreatitis.- Standards in Surgical Treatment of Chronic Pancreatitis.- C. Pancreatic Cancer.- Langerhans Islets Are the Origin of Ductal-Type Adenocarcinoma.- I. Imaging Procedures.- Ultrasound and Endoscopic Ultrasound in the Diagnosis of Pancreatic Tumors.- Computed Tomography and Magnetic Resonance Imaging in Pancreatic Cancer.- Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Pancreatic Tumors.- Role of Laparoscopy and Laparoscopic Ultrasound in Pancreatic Cancer.- Intraportal Ultrasonography for Evaluation of Resectability in Pancreatic Cancer.- II. Other Diagnostic Procedures.- Serological Diagnosis of Pancreatic Cancer.- Role of Cytology in the Diagnosis of Pancreatic Tumors.- Scintigraphic Procedures in the Detection of Pancreatic Tumors: Role of Fluorodeoxyglucose Positron Emission Tomography.- III. Molecular Biology.- Clinical Applicability of Molecular Procedures in the Diagnosis of Pancreatic Cancer.- IV. Guidelines.- Pancreatic Cancer: Diagnostic Guidelines for General Practitioners and Clinicians in Community Hospitals and Specialized Centers.

Blurb

For one whole decade, a panel of international specialists devoted itself to the study and management of pancreatic diseases, together with the different diagnostic methods available. Their diagnostic findings are reproduced in this book, which contains the proceedings of an international meeting held in Magdeburg in December 1995. The rationale for the interpretation of the findings is derived from an understanding of the basic physiological and pathophysiological events and the resultant morphological alterations. Alongside the progress made in the last 10 years in the areas of acute and chronic pancreatitis and pancreatic cancer, the panel discusses advances in laboratory and functional methods, the future of imaging, pathomorphological and molecular biological procedures, and the clinical features of the various pancreatic diseases.