Article Outline

• Copyright

This is an extensively revised and updated 2nd edition of a book initially published by Hans Beger and his colleagues in 1998. Many of the editors and authors of that earlier 2-volume edition have been replaced by new contributors and many new chapters have now been added to the text. The stated goal of this 2nd edition is “to provide the clinician with the most current … understanding of pancreatic diseases, functional assessments, diagnostic and technical devices, and treatment options.” To a great extent, this single-volume edition has achieved that goal. The book is composed of 104 chapters, grouped into 9 sections with 1 section devoted to each of the following: anatomy of the pancreas, physiology of pancreatic functions, acute pancreatitis, chronic pancreatitis, neoplastic lesions of exocrine tissue, endocrine tumors of the pancreas, periampullary tumors, other tumors of the pancreas, and transplantation of the pancreas. Although the title of this book might suggest that it covers both the exocrine and the endocrine pancreas, such is not the case. Its major focus is clearly on the exocrine pancreas, and presentations regarding the endocrine pancreas are limited to a single chapter devoted to insulo-acinar cell interactions and a single section devoted to endocrine pancreatic tumors. In essence, the resulting text covers the following 3 separate but interrelated subjects: (1) pancreatic anatomy and physiology, (2) pancreatic inflammatory diseases, and (3) pancreatic neoplastic diseases.

The chapters of this book are each well written, comprehensive, up to date, and easy to read, although the inclusion of so many chapters and the involvement of >140 authors has led to considerable chapter-to-chapter variations in text and figure style and occasional redundant presentations. On the whole, the authors of most of the chapters should be congratulated for having successfully managed to integrate basic science and clinical material.

Pancreatology is a field that is rich in uncertainty and controversy. Not surprisingly, therefore, many of the chapters in this book seem to reflect the biases of their authors, many of whom are recognized experts in their fields. On the whole, however, the material is well presented, although the chapters focused on management issues related to acute pancreatitis, chronic pancreatitis, and pancreatic tumors might benefit from additions that define the strength of the evidence supporting the authors' conclusions and recommendations. The book might also be improved by inclusion of more, and (sometimes) simpler, algorithms in the chapters devoted to testing and treatment strategies, by inclusion of a chapter devoted to the diagnosis and management of pancreatic trauma, and by inclusion of a chapter devoted to the etiologies and management of so-called benign pancreatic hyperenzymemia. The vast majority of the figures in this edition are black and white; however, selected images are also reproduced as color plates in the center of the book. The figures are well done, easily interpreted, and appropriate. Ideally, the color plates might be distributed within the various appropriate chapters but that would, most likely, unfavorably and unacceptably affect the overall cost of this already expensive book. The index is adequate and the paper quality is good. Not surprisingly, this is a large and relatively heavy book that would probably not travel well.

As a pancreatic surgeon with a scientific interest in the pathogenesis and pathophysiology of acute and chronic pancreatitis, I was drawn to the chapters devoted to those subjects and found them to be enjoyable to read, authoritative, informative, and up to date. A great strength of this book is that these chapters can be read independently. An unavoidable downside to that is that there was considerable overlap between chapters.

Bottom Line: This 2nd edition of The Pancreas: An Integrated Textbook of Basic Science, Medicine, and Surgery will serve as a standard reference work for issues related to the exocrine pancreas, pancreatitis, and both exocrine and endocrine pancreatic tumors. Much of the basic science related to the exocrine pancreas is nicely summarized in this hard cover text, and issues related to the pathophysiology, diagnosis, and management of pancreatitis, as well as pancreatic tumors, are extensively covered. The interested reader is also provided with ample and appropriate references to primary source material. Because of its cost and size, this book will probably be beyond the reach of most students, trainees, and clinicians in gastroenterology, but it would serve as an excellent and up-to-date resource for specialists who find themselves lecturing or writing about either scientific or clinical issues related to the pancreas. Furthermore, it would make an ideal addition to the libraries of most academic medical centers and medical schools.