“Don’t mess with the pancreas” is an old adage oft repeated in hospital corridors and operating theaters. This axiom is a reflection on the fragility as well as the complexity of the pancreas, one of the most fascinating organs in the human body. Management of pancreatic diseases continues to present challenging dilemmas for the clinician. Questions such as “should I start antibiotics on my patient with acute pancreatitis and fever?,” “is this patient a candidate for endoscopic drainage of a pseudocyst?,” and “what do I do with this 2-cm asymptomatic pancreatic cyst?” are routinely asked in clinical practice. The evolution of our understanding of pancreatic diseases and their management has overall evolved to a more evidence-based approach. Management paradigms continue to shift as more research comes to light. Keeping abreast of these advances is imperative for the physician managing patients with pancreatic diseases.
In this issue of Gastroenterology Clinics of North America , the focus is on discussing such advances in topics relevant to both the general gastroenterologist and the clinician with a specific interest in the pancreas. Our authors include a multidisciplinary group of recognized and emerging thought-leaders in their respective fields. A review of this issue will enable the clinician to have a better understanding of the advances in the diagnosis and management of acute pancreatitis, autoimmune pancreatitis, pancreatic cysts, and islet cell tumors of the pancreas. In addition, we have also included articles on screening for pancreatic cancer in the high-risk population—a topic that generates quite a bit of discussion and controversy at conferences. Finally, our surgical colleagues have provided comprehensive and crisp overviews of pancreas transplantation and advances in surgical management of pancreatic diseases.
I am indebted to the team of authors, who have been generous with their time and expertise in writing for this review. I am hopeful that readers will find this issue informative and edifying, with insights that will help them in the management of their patient with pancreatic diseases.