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* Due to its hidden [[Retroperitoneum|retroperitoneal]] location, the [[pancreas]] was initially termed as the ''hermit organ'' by 20<sup>th</sup> century surgeons and ignored both as an [[Organ (anatomy)|organ]] and as a seat of disease.   
* Due to its hidden [[Retroperitoneum|retroperitoneal]] location, the [[pancreas]] was initially termed as the ''hermit organ'' by 20<sup>th</sup> century surgeons and ignored both as an [[Organ (anatomy)|organ]] and as a seat of disease.   
* The [[pancreas]] was first recognized as a discrete [[Organ (anatomy)|organ]] by the Greeks.  
* The [[pancreas]] was first recognized as a discrete [[Organ (anatomy)|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 (biology)|function]].  
* '''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 (biology)|function]].  
* Rufus of Ephesus (circa 100 A.D)  coined the term [[pancreas]] (from the Greek words pan: all and '''''Kreas:''''' flesh).  
* '''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.
* The [[pancreas]], literally means all [[flesh]] due to its homogeneous composition.
'''16th century:'''  
'''16th century:'''  
* Vesalius described the [[pancreas]] and the vessels running through it, but knew nothing of the ductal system or its [[Function (biology)|function]].  
* '''Vesalius''' described the [[pancreas]] and the vessels running through it, but knew nothing of the ductal system or its [[Function (biology)|function]].  
'''17th century:'''
'''17th century:'''
*  Johann George Wirsung achieved medical immortality when he described the main [[Duct (anatomy)|duct]] of the human [[pancreas]] which currently bears his name.
'''Johann George Wirsung''' achieved medical immortality when he described the main [[Duct (anatomy)|duct]] of the human [[pancreas]] which currently bears his name.


* Regnier de Graaf utilized [[Cannula|cannulation]] and studies on [[Pancreas|pancreatic]] secretions to demonstrate the true significance of the [[pancreatic duct]].
* '''Regnier de Graaf''' utilized [[Cannula|cannulation]] and studies on [[Pancreas|pancreatic]] secretions to demonstrate the true significance of the [[pancreatic duct]].
'''18th century:'''  
'''18th century:'''  
* Albrecht Von Haller pointed out that the [[Pancreatic duct|pancreatic]] and [[Bile duct|bile ducts]] entered the intestine jointly and the function of [[Pancreas|pancreatic]] juice was to dilute [[bile]].
* '''Albrecht Von Haller''' pointed out that the [[Pancreatic duct|pancreatic]] and [[Bile duct|bile ducts]] entered the intestine jointly and the function of [[Pancreas|pancreatic]] juice was to dilute [[bile]].


* In 1742, Santorini illustrated the accessory [[Duct (anatomy)|duct]] which currently bears his name.
* In 1742, '''Santorini''' illustrated the accessory [[Duct (anatomy)|duct]] which currently bears his name.
'''19th century:'''  
'''19th century:'''  
* Willy Kuhne discovered [[trypsin]].  
* '''Willy Kuhne''' discovered [[trypsin]].  


* In 1815, Alexander discovered [[pancreatic lipase]] and its role in [[digestion]].
* In 1815, '''Alexander''' discovered [[pancreatic lipase]] and its role in [[digestion]].


=== '''History of Pancreatic cancer:''' ===
=== '''History of Pancreatic cancer:''' ===
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>
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 1679, ''Morgagni'' was the first to recognize [[Pancreatic cancer|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.
* In 1679, '''''Morgagni''''' was the first to recognize [[Pancreatic cancer|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 [[Gallbladder|gall bladder]] which is now known as the ''Curvosier’s sign'' in [[Patient|patients]] of [[pancreatic cancer]].  
* Morgagni also described a distended [[Gallbladder|gall bladder]] which is now known as the ''Curvosier’s sign'' in [[Patient|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 (anatomy)|duct]], [[acinar cell]] and [[Islets of Langerhans|islet cell]] cancers.  
* By the late 1800s, the clinical symptoms, signs and histology of [[pancreatic cancer]] had been defined. Bard and Pit differentiated between [[Duct (anatomy)|duct]], [[acinar cell]] and [[Islets of Langerhans|islet cell]] cancers.  
* In 1882, Trendelenburg was the first to successfully excise a solid tumor of the [[pancreas]].  
* 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 care|palliative therapy]] in a [[pancreatic cancer]] patient.  
* In 1887, '''Kappeler''' described the first ''cholecystojejunostomy'' performed as [[Palliative care|palliative therapy]] in a [[pancreatic cancer]] patient.  
* In 1893, Nimier published a detailed review on [[Surgery|surgical treatment]] of [[pancreatitis]] and [[pancreatic cancer]].  
* In 1893, '''Nimier''' published a detailed review on [[Surgery|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 cancer|pancreatic carcinoma]].
* In 1898, '''Codivilla''' performed a block excision of a major part of the [[duodenum]] and head of the [[pancreas]] for [[Pancreatic cancer|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 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 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]].
* 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 [[Surgery|surgeons]] world wide.
* Post 1940, the one-stage has been modified repeatedly by [[Surgery|surgeons]] world wide.
* Even today, only one tenth of the patients with [[Pancreatic cancer|pancreatic carcinoma]] undergo [[resection]].  
* Even today, only one tenth of the patients with [[Pancreatic cancer|pancreatic carcinoma]] undergo [[resection]].  

Revision as of 00:17, 16 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sudarshana Datta, MD [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

The history of the pancreas is as follows:[1]

  • 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.

18th century:

  • In 1742, Santorini illustrated the accessory duct which currently bears his name.

19th century:

History of Pancreatic cancer:

The history of the pancreatic cancer is as follows:[2][3][4][5][6]

References

  1. Lamadrid Montemayor F, Rico Nieva P (1972). "[Analgesic and antiphlogistic action of benzidamine in obstetrics]". Ginecol Obstet Mex (in Spanish; Castilian). 32 (190): 209–12. PMID 4560737.
  2. 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.
  3. 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.
  4. 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.
  5. 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).
  6. 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.