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Table of Contents
Vol. 29, Suppl. 1, 2011
Issue release date: November 2011
Section title: Paper
Dig Dis 2011;29(suppl 1):9–16
(DOI:10.1159/000331682)

Update Lecture: Benign Diseases of the Exocrine Pancreas

Mössner J.
Division of Gastroenterology and Rheumatology, Department of Medicine, Neurology and Dermatology, University Hospital Leipzig, Leipzig, Germany

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Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: November 15, 2011
Issue release date: November 2011

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 0257-2753 (Print)
eISSN: 1421-9875 (Online)

For additional information: http://www.karger.com/DDI

Abstract

A brief overview on the physiology and regulation of digestive enzyme secretion by the exocrine pancreas is presented. Knowledge about the physiology of the exocrine pancreas should help for a better understanding of the pathophysiology of both acute and chronic pancreatitis. In the pathophysiology of acute pancreatitis, fusion of zymogen granules with lysosomes, which leads to intracellular activation of trypsinogen, is still regarded as a key step in pathophysiology. The role of activation by cathepsins and the role of autoactivation of trypsinogen are still under debate. Studies on genetic alterations in various forms of human chronic pancreatitis can be interpreted that an imbalance between protease inhibitors and active proteases plays a key role. Toxic Ca2+ signals by excessive liberation from the endoplasmic reticulum may play another role. The mortality of necrotizing pancreatitis is still high. Early mortality is caused by a systemic inflammatory response syndrome with or without concomitant infection of necrosis; late mortality by multi-organ failure syndrome due to sepsis. Therapy of necroses should be performed as late as possible. A step-up approach using CT-guided and/or transgastric endoscopic necrosectomy seems to be superior to a primary surgical approach. A brief overview of the German S3 guidelines, not yet published, regarding diagnosis and treatment of chronic pancreatitis is presented.

© 2011 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: November 15, 2011
Issue release date: November 2011

Number of Print Pages: 8
Number of Figures: 3
Number of Tables: 3

ISSN: 0257-2753 (Print)
eISSN: 1421-9875 (Online)

For additional information: http://www.karger.com/DDI


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