Diagnostic Procedures in Pancreatic Disease

ISBN-13: 9783642711305 / Angielski / Miękka / 2011 / 331 str.

Peter Malfertheiner; Hans Ditschuneit

Opis

The development and improvement of new technologies have made pancreatic disease more accessible to diagnosis in the last decade. The cooperation and coordination of experts in the fields of gastro enterology, radiology, biochemistry, immunology, and pathology are necessary if the methods are to be made available and the progress made to be fully exploited. Each of the new methods requires special training, and extensive experience is needed to guarantee high standards in the diagnosis of pancreatic disease. New methods have to be tested carefully against established diagnostic procedures, though at the same time we must be ready to adopt a new approach to diagnosis. The aim of this book is to update the material already published and to focus on the various imaging methods and functional tests currently available, the features specific for each, and their integrative potential in the detection of pancreatic disease. The various pathologic findings are analyzed with reference to the clinical stages of pancreatic disease. As an introduction to the morphological and functional features of acute pancreatitis, chronic pancreatitis, and pancreatic cancer revealed by the different imaging methods and functional tests, basic knowledge of the patho-physiological and pathomorphological events is provided by research workers. This knowledge is essential for the understanding and interpretation of the diagnostic findings recorded in pancreatic diseases."

Spis treści

Introductory Remarks.- Revised Marseille Classification of Pancreatitis.- Clinical Symptoms and Signs in Pancreatic Diseases.- A. Acute Pancreatitis.- Pathomorphology of Acute Pancreatitis in Relation to Its Clinical Course and Pathogenesis.- I. Imaging Procedures.- Ultrasound in Acute Pancreatitis.- Controversies and Limitations of Ultrasonography in Acute Pancreatitis.- Computed Tomography in Acute Pancreatitis.- Grading of Acute Pancreatitis by Computed Tomography Morphology.- Preoperative Endoscopic Retrograde Pancreatography in Acute Pancreatitis.- How do Imaging Methods Influence the Surgical Strategy in Acute Pancreatitis?.- II. Functional Methods.- Entry of Pancreatic Enzymes into the Circulation.- Role of Pancreatic Enzymes in Acute Pancreatitis.- Methodological Progress in Pancreatic Enzyme Determination.- Immunochemical Methods of Pancreatic Enzyme Determination.- Value of Pancreatic Serum Enzyme Determination for Diagnosis of Acute Pancreatitis.- Is There a Most Useful Parameter for the Diagnosis of Acute Pancreatitis?.- Serum and Urinary Pancreatic Enzymes in Differential Diagnosis of Acute Pancreatitis.- III. Prognostic Evaluation.- Which Factors are of Value in the Prognosis of Acute Pancreatitis?.- Antiproteases and Nonspecific Inflammatory Parameters in the Monitoring of Acute Pancreatitis.- Correlation of Imaging Procedures, Biochemical Parameters, and Clinical Stage in Acute Pancreatitis.- Outcome of Necrotizing Pancreatitis in Relation to Morphological Parameters.- B. Chronic Pancreatitis.- Pathomorphology of Chronic Pancreatitis.- I. Imaging Procedures.- Ultrasound in Chronic Pancreatitis.- Critical Evaluation and Controversial Points of Ultrasound Findings in Chronic Pancreatitis.- Computed Tomography in Chronic Pancreatitis.- Critical Evaluation and Controversial Points of Computed Tomography Findings in Chronic Pancreatitis.- Endoscopic Retrograde Pancreatography Findings and Their Grading in Chronic Pancreatitis.- Limitations in the Interpretation of Endoscopic Retrograde Pancreatography Findings in Chronic Pancreatitis.- Ultrasound, Computed Tomography and Endoscopic Retrograde Pancreatography in the Diagnosis of Chronic Pancreatitis: A Comparative Evaluation.- II. Function Tests.- Regulation of Enzyme, Electrolyte, and Fluid Secretion in the Exocrine Pancreas.- Pancreatic Function Test by Means of Duodenal Intubation.- Biochemical Markers of Chronic Pancreatitis.- Indirect Pancreatic Function Test with NBT-PABA.- The Indirect Pancreatic Function Test “Pancreolauryl” in Chronic Pancreatitis.- Fecal Chymotrypsin in Chronic Pancreatitis Disease.- Fat Digestion Tests: Stool Analysis and Radiolabelled Tests.- Serum Enzymes in Diagnosis of Chronic Pancreatitis.- Endocrine Parameters in the Diagnosis of Chronic Pancreatitis.- Combined Functional and Morphological Diagnostic Approach in Chronic Pancreatitis.- Correlation of Morphological Lesions, Functional Changes, and Clinical Stages in Chronic Pancreatitis.- C. Pancreatic Cancer.- Pathomorphology of Pancreatic Cancer.- Parenchymal Imaging in Pancreatic Cancer.- Ductal Imaging in Pancreatic Cancer.- Ultrasound-Guided Fine-Needle Biopsy in the Diagnosis of Pancreatic Tumors.- Cytological Diagnosis of Pancreatic Tumors.- New Antigens and Monoclonal Antibodies for Serological Diagnosis, Follow-up, and Scintigraphic Localization in Pancreatic Cancer.- Monoclonal Antibodies in Pancreatic Cancer: New Developments.