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==Overview==
==Overview==
Pancreatic cancer was first discovered in the 18th-century by Italian scientist Giovanni Battista Morgagni.   
Herophilus of Chalcedon (circa 300 B.C.), the Father of Scientific Anatomy, was the first to describe the pancreas but he had no conception of its function. Rufus of Ephesus (circa 100 A.D)  coined the term pancreas (from the Greek words pan: all and '''''Kreas:''''' flesh). It literally means all flesh due to its homogeneous composition. In 1679, Morgagni was the first to recognize cancer of the pancreas and described the pancreas of one of his patients as a dry white pancreas of a scirrhous nature with “pretty hard” distinct lobules. By the late 1800s, the clinical symptoms, signs and histology of pancreatic cancer had been defined. Bard and Pit differentiated between duct, acinar cell and islet cell cancers. Trendelenburg was the first to successfully excise a solid tumor of the pancreas and  Kappeler described the first cholecystojejunostomy performed as palliative therapy in a pancreatic cancer patient. In February 1955, Whipple performed a two stage operation for carcinoma of the ampulla, where a cholecystojejunostomy and total duodenectomy were performed. This was the first total duodenectomy to be recorded in a human subject. In 1940, Whipple and Nelson performed the first ever recorded one-stage pancreaticoduodenectomy followed by occlusion of  the pancreas.Post 1940, the one-stage has been modified repeatedly by surgeons world wide. The treatment of pancreatic cancer continues to be a dilemma. However, the mortality rate for pancreatoduodenal resection has declined from 21 percent before 1970 to 0 percent after 1970.   
 
==Historical Perspective==
==Historical Perspective==
The history of the pancreatic cancer is as follows:<ref name="Busnardo-1983">{{cite journal | author = Busnardo AC, DiDio LJ, Tidrick RT, Thomford NR | title = History of the pancreas | journal = American Journal of Surgery | volume = 146 | issue = 5 | pages = 539–50 | year = 1983 | pmid = 6356946 | doi = 10.1016/0002-9610(83)90286-6 | url = http://www.sciencedirect.com/science/article/pii/0002961083902866/pdfft?md5=34f4309b3b458333f9ba746946125abb&pid=1-s2.0-0002961083902866-main.pdf }}</ref><ref name="History">{{cite journal | author = Are C, Dhir M, Ravipati L | title = History of pancreaticoduodenectomy: early misconceptions, initial milestones and the pioneers | journal = HPB : the official journal of the International Hepato Pancreato Biliary Association | volume = 13 | issue = 6 | pages = 377–84 | date = June 2011 | pmid = 21609369 | doi = 10.1111/j.1477-2574.2011.00305.x }}</ref><ref name="Thousand">{{cite journal | author = Cameron JL, Riall TS, Coleman J, Belcher KA | title = One thousand consecutive pancreaticoduodenectomies | journal = Annals of surgery | volume = 244 | issue = 1 | pages = 10–5 | date = July 2006 | pmid = 16794383 | doi = 10.1097/01.sla.0000217673.04165.ea }}</ref><ref name="pmid20664470 [">{{cite journal| author=Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S| title=The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. | journal=Pancreas | year= 2010 | volume= 39 | issue= 6 | pages= 707-12 | pmid=20664470 [ | doi=10.1097/MPA.0b013e3181ec124e | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20664470  }} </ref><ref>{{cite journal | author = Fernández-del Castillo C, Morales-Oyarvide V, McGrath D, Wargo JA, Ferrone CR, Thayer SP, Lillemoe KD, Warshaw AL | title = Evolution of the Whipple procedure at the Massachusetts General Hospital | journal = Surgery | volume = 152 | issue = 3 Suppl 1 | pages = S56–63 | date = September 2012 | pmid = 22770961 | pmc = 3806095 | doi = 10.1016/j.surg.2012.05.022 }}</ref>  
 
* Another series of 2,050 operations at the [[Massachusetts General Hospital]] between 1941 and 2011 showed a similar picture of improvement.
=== History of the pancreas ===
* In 2010, the WHO recommended that PanNETs be referred to as "neuroendocrine" rather than "endocrine" tumors.
* Due to its hidden retroperitoneal location, the pancreas was initially termed as the hermit organ by 20<sup>th</sup> century surgeons and ignored both as an organ and as a seat of disease. 
* The earliest recognition of pancreatic cancer has been attributed to the 18th-century Italian scientist [[Giovanni Battista Morgagni]],
* The pancreas was first recognized as a discrete organ by the Greeks.
* Morgagni is the historical father of modern-day [[anatomic pathology]], who claimed to have traced several cases of cancer in the pancreas.
* Herophilus of Chalcedon (circa 300 B.C.), the Father of Scientific Anatomy, was the first to describe the pancreas but he had no conception of its function.
* Many 18th and 19th-century physicians were skeptical about the existence of the disease, given the similar appearance of pancreatitis.  
* Rufus of Ephesus (circa 100 A.D)  coined the term pancreas (from the Greek words pan: all and '''''Kreas:''''' flesh).
* Some [[case report]]s were published in the 1820s and 1830s, and a genuine [[histopathologic]] diagnosis was eventually recorded by the American clinician [[Jacob Mendes Da Costa]], who also doubted the reliability of Morgagni's interpretations.  
* The pancreas, literally means all flesh due to its homogeneous composition.
* By the start of the 20th century, cancer of the head of the pancreas had become a well-established diagnosis.
'''16th century:'''
* Regarding the recognition of PanNETs, the possibility of cancer of the islet cells was initially suggested in 1888.  
* Vesalius described the pancreas and the vessels running through it, but knew nothing of the ductal system or its function.
* The first case of [[hyperinsulinism]] due to a tumor of this type was reported in 1927.  
'''17th century:'''
* Recognition of a non-insulin-secreting type of PanNET is generally ascribed to the American surgeons, R.&nbsp;M. Zollinger and E.&nbsp;H. Ellison, who gave their names to Zollinger–Ellison syndrome, after postulating the existence of a gastrin-secreting pancreatic tumor in a report of two cases of unusually severe [[peptic ulcer]]s published in 1955.
*  Johann George Wirsung achieved medical immortality when he described the main duct of the human pancreas which currently bears his name.
* The first reported partial pancreaticoduodenectomy was performed by the Italian surgeon Alessandro Codivilla in 1898, but the patient only survived 18 days before succumbing to complications.  
 
* Early operations were compromised partly because of mistaken beliefs that people would die if their duodenum was removed, and also, at first, if the flow of pancreatic juices stopped.
* Regnier de Graaf utilized cannulation and studies on pancreatic secretions to demonstrate the true significance of the pancreatic duct.
* Later it was thought that the pancreatic duct could simply be tied up without serious adverse effects; in fact it will very often leak later on. 
'''18th century:'''
* In 1907-08, after some more unsuccessful operations by other surgeons, experimental procedures were tried on corpses by French surgeons.
* Albrecht Von Haller pointed out that the pancreatic and bile ducts entered the intestine jointly and the function of pancreatic juice was to dilute bile.
* In 1912 the German surgeon Walther Kausch was the first to remove large parts of the duodenum and pancreas together (''en bloc'') in Breslau, now Wrocław in Poland.  
 
* In 1918 it was demonstrated in operations on dogs that total removal of the duodenum is compatible with life, but this was not reported in human surgery until 1935, when the American surgeon Allen Old father Whipple published the results of a series of three operations at Columbia Presbyterian Hospital in New York.
* In 1742, Santorini illustrated the accessory duct which currently bears his name.
* Only one of the patients had the duodenum totally removed, but he survived for two years before dying of metastasis to the liver.
'''19th century:'''
* The first operation was unplanned, as cancer was only discovered in the operating theater.
* Willy Kuhne discovered trypsin.
* Whipple's success showed the way for the future, but the operation remained a difficult and dangerous one until recent decades. He published several refinements to his procedure, including the first total removal of the duodenum in 1940, but he only performed a total of 37 operations.
 
* The discovery in the late 1930s that [[vitamin&nbsp;K]] prevented [[Vitamin K deficiency|bleeding with jaundice]], and the development of [[blood transfusion]] as an everyday process, both improved post-operative survival.
* In 1815, Alexander discovered pancreatic lipase and its role in digestion.
* In 1970s a group of American surgeons wrote urging that the procedure was too dangerous and should be abandoned.  
 
* Since then outcomes in larger centers have improved considerably, and mortality from the operation is often less than 4%.
=== '''History of Pancreatic cancer:''' ===
* One type, the intraductal papillary mucinous neoplasm (IPMN) was first described by Japanese researchers in 1982; "For the next decade, little attention was paid to this report; however, over the subsequent 15 years, there has been a virtual explosion in the recognition of this tumor.
The history of the pancreatic cancer is as follows:<ref name="Busnardo-1983">{{cite journal | author = Busnardo AC, DiDio LJ, Tidrick RT, Thomford NR | title = History of the pancreas | journal = American Journal of Surgery | volume = 146 | issue = 5 | pages = 539–50 | year = 1983 | pmid = 6356946 | doi = 10.1016/0002-9610(83)90286-6 | url = http://www.sciencedirect.com/science/article/pii/0002961083902866/pdfft?md5=34f4309b3b458333f9ba746946125abb&pid=1-s2.0-0002961083902866-main.pdf }}</ref><ref name="History">{{cite journal | author = Are C, Dhir M, Ravipati L | title = History of pancreaticoduodenectomy: early misconceptions, initial milestones and the pioneers | journal = HPB : the official journal of the International Hepato Pancreato Biliary Association | volume = 13 | issue = 6 | pages = 377–84 | date = June 2011 | pmid = 21609369 | doi = 10.1111/j.1477-2574.2011.00305.x }}</ref><ref name="Thousand">{{cite journal | author = Cameron JL, Riall TS, Coleman J, Belcher KA | title = One thousand consecutive pancreaticoduodenectomies | journal = Annals of surgery | volume = 244 | issue = 1 | pages = 10–5 | date = July 2006 | pmid = 16794383 | doi = 10.1097/01.sla.0000217673.04165.ea }}</ref><ref name="pmid20664470 [">{{cite journal| author=Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S| title=The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems. | journal=Pancreas | year= 2010 | volume= 39 | issue= 6 | pages= 707-12 | pmid=20664470 [ | doi=10.1097/MPA.0b013e3181ec124e | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20664470  }} </ref><ref>{{cite journal | author = Fernández-del Castillo C, Morales-Oyarvide V, McGrath D, Wargo JA, Ferrone CR, Thayer SP, Lillemoe KD, Warshaw AL | title = Evolution of the Whipple procedure at the Massachusetts General Hospital | journal = Surgery | volume = 152 | issue = 3 Suppl 1 | pages = S56–63 | date = September 2012 | pmid = 22770961 | pmc = 3806095 | doi = 10.1016/j.surg.2012.05.022 }}</ref>
* In 2006 a report was published on a series of 1,000 consecutive pancreaticoduodenectomies performed by a single surgeon from [[Johns Hopkins Hospital]] between 1969 and 2003.  
* In 1679, Morgagni was the first to recognize cancer of the pancreas and described the pancreas of one of his patients as a dry white pancreas of a scirrhous nature with “pretty hard” distinct lobules.
* The rate of these operations had increased steadily over this period, with only three of them before 1980, and the median operating time reduced from 8.8&nbsp;hours in the 1970s to 5.5&nbsp;hours in the 2000s, and mortality within 30 days or in hospital was only 1%.
* Morgagni also described a distended gall bladder which is now known as the Curvosier’s sign in patients of pancreatic cancer.  
* Small precancerous neoplasms for many pancreatic cancers are being detected at greatly increased rates by modern medical imaging.
* By the late 1800s, the clinical symptoms, signs and histology of pancreatic cancer had been defined. Bard and Pit differentiated between duct, acinar cell and islet cell cancers.  
* In 1882, Trendelenburg was the first to successfully excise a solid tumor of the pancreas.  
* In 1887, Kappeler described the first cholecystojejunostomy performed as palliative therapy in a pancreatic cancer patient.  
* In 1893, Nimier published a detailed review on surgical treatment of pancreatitis and pancreatic cancer.  
* In 1898, Codivilla performed a block excision of a major part of the duodenum and head of the pancreas for pancreatic carcinoma.
*  in 1912, Kausch carried out the first successful two stage partial pancreaticoduodectomy , where he implanted the stump of the resected pancreas into the distal stump of the resected duodenum.  
* In February 1955, Whipple performed a two stage operation for carcinoma of the ampulla, where a cholecystojejunostomy  and total duodenectomy were performed. This was the first total duodenectomy to be recorded in a human subject.  
 
* In 1940, Whipple and Nelson performed the first ever recorded one-stage pancreaticoduodenectomy followed by occlusion of  the pancreas.
* Post 1940, the one-stage has been modified repeatedly by surgeons world wide.
* Even today, only one tenth of the patients with pancreatic carcinoma undergo resection.  
* The mortality rate for pancreatoduodenal resection has declined from 21 percent before 1970 to 0 percent after 1970, but the five year survival rate is still in the range of 5 to 8 percent.


==References==
==References==

Revision as of 22:52, 15 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Overview

Herophilus of Chalcedon (circa 300 B.C.), the Father of Scientific Anatomy, was the first to describe the pancreas but he had no conception of its function. Rufus of Ephesus (circa 100 A.D)  coined the term pancreas (from the Greek words pan: all and Kreas: flesh). It literally means all flesh due to its homogeneous composition. In 1679, Morgagni was the first to recognize cancer of the pancreas and described the pancreas of one of his patients as a dry white pancreas of a scirrhous nature with “pretty hard” distinct lobules. By the late 1800s, the clinical symptoms, signs and histology of pancreatic cancer had been defined. Bard and Pit differentiated between duct, acinar cell and islet cell cancers. Trendelenburg was the first to successfully excise a solid tumor of the pancreas and Kappeler described the first cholecystojejunostomy performed as palliative therapy in a pancreatic cancer patient. In February 1955, Whipple performed a two stage operation for carcinoma of the ampulla, where a cholecystojejunostomy and total duodenectomy were performed. This was the first total duodenectomy to be recorded in a human subject. In 1940, Whipple and Nelson performed the first ever recorded one-stage pancreaticoduodenectomy followed by occlusion of the pancreas.Post 1940, the one-stage has been modified repeatedly by surgeons world wide. The treatment of pancreatic cancer continues to be a dilemma. However, the mortality rate for pancreatoduodenal resection has declined from 21 percent before 1970 to 0 percent after 1970.

Historical Perspective

History of the pancreas

  • Due to its hidden retroperitoneal location, the pancreas was initially termed as the hermit organ by 20th century surgeons and ignored both as an organ and as a seat of disease.
  • The pancreas was first recognized as a discrete organ by the Greeks.
  • Herophilus of Chalcedon (circa 300 B.C.), the Father of Scientific Anatomy, was the first to describe the pancreas but he had no conception of its function.
  • Rufus of Ephesus (circa 100 A.D)  coined the term pancreas (from the Greek words pan: all and Kreas: flesh).
  • The pancreas, literally means all flesh due to its homogeneous composition.

16th century:

  • Vesalius described the pancreas and the vessels running through it, but knew nothing of the ductal system or its function.

17th century:

  • Johann George Wirsung achieved medical immortality when he described the main duct of the human pancreas which currently bears his name.
  • Regnier de Graaf utilized cannulation and studies on pancreatic secretions to demonstrate the true significance of the pancreatic duct.

18th century:

  • Albrecht Von Haller pointed out that the pancreatic and bile ducts entered the intestine jointly and the function of pancreatic juice was to dilute bile.
  • In 1742, Santorini illustrated the accessory duct which currently bears his name.

19th century:

  • Willy Kuhne discovered trypsin.
  • In 1815, Alexander discovered pancreatic lipase and its role in digestion.

History of Pancreatic cancer:

The history of the pancreatic cancer is as follows:[1][2][3][4][5]

  • In 1679, Morgagni was the first to recognize cancer of the pancreas and described the pancreas of one of his patients as a dry white pancreas of a scirrhous nature with “pretty hard” distinct lobules.
  • Morgagni also described a distended gall bladder which is now known as the Curvosier’s sign in patients of pancreatic cancer.
  • By the late 1800s, the clinical symptoms, signs and histology of pancreatic cancer had been defined. Bard and Pit differentiated between duct, acinar cell and islet cell cancers.
  • In 1882, Trendelenburg was the first to successfully excise a solid tumor of the pancreas.
  • In 1887, Kappeler described the first cholecystojejunostomy performed as palliative therapy in a pancreatic cancer patient.
  • In 1893, Nimier published a detailed review on surgical treatment of pancreatitis and pancreatic cancer.
  • In 1898, Codivilla performed a block excision of a major part of the duodenum and head of the pancreas for pancreatic carcinoma.
  •  in 1912, Kausch carried out the first successful two stage partial pancreaticoduodectomy , where he implanted the stump of the resected pancreas into the distal stump of the resected duodenum.
  • In February 1955, Whipple performed a two stage operation for carcinoma of the ampulla, where a cholecystojejunostomy and total duodenectomy were performed. This was the first total duodenectomy to be recorded in a human subject.
  • In 1940, Whipple and Nelson performed the first ever recorded one-stage pancreaticoduodenectomy followed by occlusion of the pancreas.
  • Post 1940, the one-stage has been modified repeatedly by surgeons world wide.
  • Even today, only one tenth of the patients with pancreatic carcinoma undergo resection.
  • The mortality rate for pancreatoduodenal resection has declined from 21 percent before 1970 to 0 percent after 1970, but the five year survival rate is still in the range of 5 to 8 percent.

References

  1. ↑ Busnardo AC, DiDio LJ, Tidrick RT, Thomford NR (1983). "History of the pancreas" (PDF). American Journal of Surgery. 146 (5): 539–50. doi:10.1016/0002-9610(83)90286-6. PMID 6356946.
  2. ↑ Are C, Dhir M, Ravipati L (June 2011). "History of pancreaticoduodenectomy: early misconceptions, initial milestones and the pioneers". HPB : the official journal of the International Hepato Pancreato Biliary Association. 13 (6): 377–84. doi:10.1111/j.1477-2574.2011.00305.x. PMID 21609369.
  3. ↑ Cameron JL, Riall TS, Coleman J, Belcher KA (July 2006). "One thousand consecutive pancreaticoduodenectomies". Annals of surgery. 244 (1): 10–5. doi:10.1097/01.sla.0000217673.04165.ea. PMID 16794383.
  4. ↑ Klimstra DS, Modlin IR, Coppola D, Lloyd RV, Suster S (2010). "The pathologic classification of neuroendocrine tumors: a review of nomenclature, grading, and staging systems". Pancreas. 39 (6): 707–12. doi:10.1097/MPA.0b013e3181ec124e. PMID [ 20664470 [ Check |pmid= value (help).
  5. ↑ Fernández-del Castillo C, Morales-Oyarvide V, McGrath D, Wargo JA, Ferrone CR, Thayer SP, Lillemoe KD, Warshaw AL (September 2012). "Evolution of the Whipple procedure at the Massachusetts General Hospital". Surgery. 152 (3 Suppl 1): S56–63. doi:10.1016/j.surg.2012.05.022. PMC 3806095. PMID 22770961.
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