As we began to plan this book about 10 years ago, we wanted to write a practical book for medical students, doctors in training, internists, gas and surgeons faced with everyday clinical problems in troenterologists, the care of patients with acute and chronic pancreatitis. Now, 10 years lat er, our book has become much more than what we had originally intend ed, with so many new findings that have expanded our knowledge of pancreatic diseases, not to mention new imaging procedures and con trolled studies on the effectiveness of various therapies. Consequently, we decided to include: - The state-of-the-art on diagnosis and therapy in inflammatory pan creatic diseases - Recommendations for diagnosis and therapy based on the published results from experienced clinicians. In the many areas still untested we have relied on the decades of experience of the two authors on both sides of the Atlantic - A discussion of unanswered questions for future research by physi cians interested in pancreatitis who can draw upon our bibliography of almost 1900 references complete through 1996. We also wanted to demonstrate with this work that two authors from two continents can come to common conclusions that can help physicians and students in their everyday clinical work and their clinical research. It is with deep gratitude that we acknowledge the assistance of Mrs. Gisela Ropte for years of patient cooperation, great precision, and initia tive, as well as that of Dr. Dr.

1 General Considerations: Embryology

1.1 Normal Development
1.2 Congenital Abnormalities
References
2 General Considerations: Anatomy
References
3 General Considerations: Physiology
3.1 Function of the Exocrine Pancreas
3.2 Pancreatic Enzymes
3.3 Enzyme Synthesis
3.4 Protective Mechanisms to Prevent Autodigestion
3.5 Pancreatic Secretagogues
3.6 Phases of Pancreatic Secretion
3.7 Ductular Secretion
3.8 Acinar Secretion
3.9 Action of Pancreatic Lipase
3.10 What Turns the Pancreas Off?
References
4 General Considerations: Classification
4.1 Marseille Classification of 1963
4.2 Cambridge Classification of 1983
4.3 Revised Pancreatitis Classification of Marseille 1984
4.4 Pancreatitis Classification of Marseille-Rome 1988
4.5 Pancreatitis Classification - Cambridge vs. Marseille: Features in Common and Differences
4.6 Classification System for Acute Pancreatitis of Atlanta 1992
4.7 Comment
References
5 Acute Pancreatitis: Etiology
5.1 Biliary Tract Disease
5.2 Alcoholism
5.3 Obstruction of Pancreatic Ducts
5.4 Infections
5.5 Drugs
5.6 Toxins
5.7 Endocrine and Metabolic Disorders
5.8 Vascular Disease
5.9 Trauma
5.10 Medical Procedures
5.11 Surgical Procedures
5.12 Cystic Fibrosis
5.13 Inborn Errors of Metabolism
5.14 Reye's Syndrome
5.15 Kawasaki Disease
5.16 Hereditary Acute Pancreatitis
5.17 Idiopathic Acute Pancreatitis
References
6 Acute Pancreatitis: Pathophysiology
6.1 Mechanisms of Pancreatic Injury
6.2 Gallstone-induced Acute Pancreatitis
6.3 Alcohol-induced Acute Pancreatitis
6.4 Concept of Oxidative Stress
6.5 Theories Explaining the Pathogenetic Mechanism of Acute Biliary Pancreatitis
6.6 The Pros and Cons of the Theories
References
7 Acute Pancreatitis:Pathology
7.1 Gross Pathology
7.2 Histopathology
7.3 Sequential Changes and Outcome
References
8 Acute Pancreatitis: Epidemiology
References
9 Acute Pancreatitis: Diagnosis
9.1 Clinical Manifestation
9.2 Laboratory Investigations
9.3 Imaging Procedures
9.4 Synopsis of Diagnostic Procedures and Grading of Severity
References
10 Acute Pancreatitis: Complications
10.1 Local Complications
10.2 Systemic and Other Extrapancreatic Complications
References
11 Acute Pancreatitis:Treatment
11.1 Basic Treatment
11.2 Treatment of Local Complications
11.3 Treatment of Systemic Complications
11.4 Treatment of Metabolic Complications
11.5 Treatment of Extrapancreatic Complications
References
12 Acute Pancreatitis: Prognosis
12.1 Introduction
12.2 Etiology
12.3 Initial or Repeated Episodes
12.4 Severity
12.5 Systemic Complications
12.6 Mortality
12.7 Late Morphological and Functional Consequences of the Pancreas
12.8 Quality of Life
References
13 Chronic Pancreatitis: Etiology
13.1 Alcohol-induced Chronic Pancreatitis
13.2 Idiopathic Chronic Pancreatitis
13.3 Tropical Pancreatitis
13.4 Hereditary Diseases of the Pancreas
13.5 Congenital Abnormalities Including Pancreas Divisum
13.6 Obstructive Chronic Pancreatitis
13.7 Drug-induced Chronic Pancreatitis
13.8 Stress-induced Chronic Pancreatitis
13.9 Radiation-induced Chronic Pancreatitis
13.10 Hyperparathyroidism
References
14 Chronic Pancreatitis: Pathophysiology
14.1 Concept of Primary Intraductal Obstruction
14.2 Concept of Primary Toxic-Metabolic Action of Alcohol
14.3 Concept of Oxidative Stress
14.4 Concept of Necrosis-Fibrosis Sequence
References
15 Chronic Pancreatitis: Pathology
15.1 Gross Pathology
15.2 Histopathology.-15.3 Chronic Pancreatitis With Focal Necrosis
15.4 Chronic Pancreatitis With Segmental or Diffuse Fibrosis
15.5 Obstructive Chronic Pancreatitis
References
16 Chronic Pancreatitis: Epidemiology
References
17 Chronic Pancreatitis: Diagnosis
17.1 Clinical Manifestation
17.2 Laboratory Investigations
17.3 Imaging Procedures
17.4 Synopsis of Diagnostic Procedures
References
18 Chronic Pancreatitis: Complications
18.1 General
18.2 Intrapancreatic Complications
18.3 Extrapancreatic Complications
References
19 Chronic Pancreatitis: Treatment
19.1 Pain
19.2 Exocrine Pancreatic Insufficiency
19.3 Endocrine Pancreatic Insufficiency
19.4 Postoperative Syndromes
19.5 Evaluation of Follow-up Results
References
20 Chronic Pancreatitis: Prognosis
20.1 Introduction
20.2 Pain
20.3 Exocrine Pancreatic Insufficiency
20.4 Endocrine Pancreatic Insufficiency
20.5 Complications
20.6 Pancreatic and Extrapancreatic Carcinomas
20.7 Quality of Life
20.8 Mortality
20.9 Factors of Prognosis
References
21 Addendum: Hereditary Pancreatic Diseases
21.1 Hereditary Pancreatic Diseases Associated With Exocrine Pancreatic Insufficiency
21.2 Hereditary Diseases of the Exocrine Pancreas Associated With Pancreatitis
References.