目录
目 录
Contributors
Preface
Abbreviations
1 A Short History of Research into Chronic Pancreatitis
1 Introduction
2 Etiology and Pathogenesis
3 Diagnosis
4 Treatment
References
2 Definition and Classification of Chronic Pancreatitis
1 Definition
2 Classification
3 M-ANNHEIM Multiple Risk Factors
4 M-ANNHEIM Clinical Staging of Chronic Pancreatitis
5 Proposed Staging/Classification of CP（Stages A）
5.1 Specific Definition of CP Stage A
5.2 Specific Definition of CP Stage B
5.3 Specific Definition of CP Stage C
6 TIGAR-O System
References
3 The Epidemiology of Chronic Pancreatitis
1 Descriptive Epidemiology
1.1 Incidence and Prevalence
1.2 Age and Gender
1.3 Race
1.4 Mortality
2 Risk Factors
2.1 Alcohol
2.2 Smoking
2.3 Diseases
References
4 Etiology of Chronic Pancreatitis
1 Why Etiology Is the Cornerstone of the Disease
2 How Many People Have This Disease Right Now？
3 The Etiology of Chronic Pancreatitis in Western Countries and in Japan
4 The Etiology of Chronic Pancreatitis in Low and Middle-Income Countries
5 The Significance of Etiology in Chronic Pancreatitis
6 OtherEtiologies of Chronic Pancreatitis
6.1 Genetic Disorders
6.2 Autoimmune Diseases
7 The Changes in Lifestyle
8 The Frequency of Change in Etiology
References
5 The Pathogenesis of Chronic Pancreatitis
1 Pain Mechanisms in Chronic Pancreatitis
1.1 “Plumbing”Problems
1.2 “Wiring”Problems
1.3 Pancreatic and Extra-Pancreatic Complications
1.4 Side Effects to Treatment
1.5 Conclusion
2 The Mechanism of Pancreatic Stone Formation
2.1 Introduction
2.2 Analysis of Chemical Composition in Pancreatic Stones
2.3 Mechanisms of Pancreatic Stones Formation
2.4 Conclusion
3 Experimental Models of Chronic Pancreatitis
3.1 Features of Chronic Pancreatitis
3.2 Animal Models for Chronic Pancreatitis
3.3 Duct Obstruction Models
3.4 Repeated Caerulein Models
3.5 Alcohol Feeding Models
3.6 Genetic Models
3.7 Concluding Remarks
References
6 Pathogenetics of Chronic Pancreatitis
1 A Conservative Assessment of the Major Genetic Causes of ICP
2 The Emerging Pathway of Misfolding-Induced ERS in the Aetiology of Chronic Pancreatitis
3 The First GWAS Study of Chronic Pancreatitis
3.1 Identification of a Protective Single Nucleotide Polymorphism in the PRSS1-PRSS2 Locus
3.2 Identification of a Risk SNP in the CLDN2 Locus
4 Rare Functional CPA1 Variants and Chronic Pancreatitis
5 CEL-HYB Alleles and Chronic Pancreatitis
5.1 CEL-HYB Allele Discovery
5.2 The CEL-HYB Allele Probably Represents an Ethnicity-Specific Risk Factor
5.3 Molecular Mechanisms Underlying the Contrasting Phenotypes of CEL-HYB 1 and CEL-HYB2
5.4 Implications for Variant Discovery in Complex Regions of the Human Genome
6 Some Other Recent Developments
6.1 A Comprehensive Functional Annotation of SPINK1 Intronic Variants
6.2 An Explanation for Why No Chronic Pancreatitis-Predisposing Variants in the PRSS2 Gene Have Ever Been Described
6.3 A Novel Disease-Causing Gene Conversion Mutation in the PRSS1 Gene
6.4 A Chronic-Pancreatitis-Associated CTRC Variant Resembling One of the Evolutionary Signatures of Human Mesotrypsinogen in Terms of Biochemical Properties
6.5 The Common CTRC Synonymous Variant（c1.80C＞T）Increases Risk of Chronic Pancreatitis But Not Recurrent Acute Pancreatitis
6.6 Biological Mechanism Underlying CFTR Variants That Increase the Risk of Pancreatitis But Not Cystic Fibrosis
6.7 ABO Blood Type B and Fucosyltransferase 2 Non-secretor Status as Genetic Risk Factors for Chronic Pancreatitis
References
7 Diagnosis of Chronic Pancreatitis
1 Diagnosis of Chronic Pancreatitis
1.1 Diagnostic Criteria of Chronic Pancreatitis
1.2 The Cambridge Classification
1.3 M-ANNHEIM Score and M-ANNHEIM Severity Index
1.4 Symptoms and Signs
1.5 Symptoms
1.6 Signs
1.7 Laboratory Tests
2 Endocrine Function Tests of Chronic Pancreatitis
2.1 Classification and Menace of Diabetes Mellitus Secondary to CP
2.2 Evaluation of CP Patients for Presence or Increased Risk of T3cDM
2.3 Differentiation Diagnosis of T3cDM from T1 DM or T2DM
2.4 Assessment of Pancreatic Endocrine Reserve in CP Patients
2.5 Other Pancreatic Endocrine Function Tests
3 Pathophysiology and Diagnosis of Pancreatic Exocrine Insufficiency in Chronic Pancreatitis
3.1 Introduction
3.2 Pathophysiology
3.3 Clinical Symptoms of Pancreatic Exocrine Insufficiency
3.4 Pancreatic Function Tests
3.5 Secretin Test
3.6 Stool Tests
3.7 Indirect Tests
3.8 13C-Breath Tests(https://www.daowen.com)
3.9 Fecal Fat Analysis
3.10 Combined Morphological and Functional Investigations
3.11 Clinical Role of Pancreatic Function Tests
4 Radiographic Examinations of Chronic Pancreatitis
4.1 Transabdominal Ultrasound（TUS）
4.2 Plain Abdominal Radiographs
4.3 Computed Tomography（CT）
4.4 CT Findings
4.5 Magnetic Resonance Imaging（MRI）
4.6 MR Findings
4.7 Differential Diagnosis
4.8 Diagnostic Strategy
5 ERCP for the Diagnosis of Chronic Pancreatitis
5.1 Introduction
5.2 Indications for Diagnostic ERCP
5.3 Classical Classification byERCP
5.4 Application of Diagnostic ERCP
5.5 Limitations of Diagnostic ERCP
5.6 Summary
6 EUS in the Diagnosis of Chronic Pancreatitis
6.1 EUS Criteria
6.2 New Techniques Associated to EUS
References
8 Conservative Management of Chronic Pancreatitis
1 N utrition and Lifestyle Modification
1.1 Life Style Changes
1.2 Diet
2 Pain Management
2.1 Analgesics
2.2 Antioxidants
2.3 Pancreatic Enzyme and the Negative Feedback Theory
3 Pancreatic Exocrine Insufficiency（PEI）
4 Pancreatic Endocrine Insufficiency
References
9 Endoscopic Management of Chronic Pancreatitis
1 Introduction
2 Pancreatic Ductal Stones
2.1 Pre-endotherapy Assessment and Patient Selection
2.2 Role of Pre-endotherapy Extracorporeal Shockwave Lithotripsy（ESWL）
2.3 Endotherapy
2.4 ESWL Alone
3 Main Pancreatic Duct Strictures
3.1 Plastic Stent
3.2 Self-Expandable Metal Stent
4 Comparison of Endoscopic Therapy with Surgery for Chronic Obstructive Pancreatitis
5 Benign Biliary Strictures
5.1 Plastic Stent
5.2 SEMS
6 Pancreatic Pseudocysts
6.1 Drainage of PP
7 Endosonography-Guided Celiac Plexus Block
8 Endoscopic Therapy and Exocrine/Endocrine Insufficiency
9 Summary
References
10 Surgical Treatment of Chronic Pancreatitis
1 Introduction
2 Indications
3 Surgical Procedures
4 Decompression and Drainage
5 Pancreatectomy
6 Neurectomy
7 Postoperative Complications
References
11 Special Types of Chronic Pancreatitis
1 Autoimmune Pancreatitis
1.1 Introduction
1.2 Epidemiology
1.3 Clinical Presentations
1.4 Imaging
1.5 Serum Markers
1.6 Histology
1.7 Other Organ Involvement（OOI）
1.8 Diagnosis Criteria for AIP
1.9 Comparison of the Clinical Presentations of Type 1 and Type 2 AIP
1.10 Treatments
1.11 Prognosis
2 Evolution of Phenotypic and Genetic Profile of Tropical Calcific Pancreatitis
2.1 Introduction
2.2 Phenotypic Perspectives
2.3 Genetic Risk Factors
2.4 Concluding Remarks
2.5 Future Directions
3 Pediatric Pancreatitis
3.1 Introduction
3.2 Risk Factors
3.3 Pathophysiology
3.4 Clinical Manifestations
3.5 Diagnostic Testing
3.6 Complications of CP in Children
References
12 Chronic Pancreatitis and Pancreatic Cancer
1 Introduction
2 Pancreatic Cancer Is Inflammatory Malignancy
3 Chronic Pancreatitis Is Malignant Driver
4 Pathways Linking Chronic Pancreatitis to Pancreatic Cancer
4.1 Extrinsic Pathways Linking Chronic Pancreatitis and Pancreatic Cancer
4.2 Intrinsic Pathways Within Pancreatic Cancer Cells Modulated by Chronic Pancreatitis
5 Common Alterations Involved in Pancreatic Cancer and Chronic Pancreatitis
6 Differential Diagnosis Between Pancreatic Cancer and Chronic Pancreatitis
7 Summary
References
13 Typical Cases of Chronic Pancreatitis
1 Typical Case 1:Alcoholic Chronic Pancreatitis
2 Typical Case 2:Chronic Pancreatitis with Main Pancreatic Duct Stricture and Upstream Dilatation
3 Typical Case 3:Chronic Pancreatitis with Pancreatic Pseudocyst
4 Typical Case 4:Adolescent Chronic Pancreatitis with Radiolucent Stones
5 Typical Case 5:Spontaneous Expulsion of Stones After ESWL
6 Typical Case 6:Autoimmune Pancreatitis
Index