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In the interest of full disclosure, I wish to say “up front” that I am not a basic scientist. I am a clinician and proceduralist who spends much of his time caring for patients with biliary and pancreatic diseases. The preface to this short book (92 pages) does not indicate the editors' expectation of this textbook. They simply state that “In September 2007, several experts in the field of pancreatic pathophysiology, supported by the North Atlantic Treaty Organization (NATO) Science Committee, met in Tashkent, Uzbekistan, to present their most recent data and discuss basic genetic, clinical and surgical aspects of pancreatic diseases.” I had not previously considered Tashkent, the capital of Uzbekistan, to be a hotbed of pancreatology, but that may be my ignorance showing. I do know that Tashkent was attacked and destroyed by Genghis Khan in 1219, but subsequently survived numerous occupations to emerge in the 21st century as the fourth largest Russian city. A brief review of the Wikipedia entry for Tashkent shows that it is a center of learning, with numerous universities and academic institutions. So, perhaps Tashkent is, indeed, a well-kept secret in the world of pancreatology.

This book is a collection of 9 chapters focusing on diverse topics, mainly basic science-related subjects pertaining to the pancreas. The final 2 chapters are on endoscopic sphincterotomy in the management of acute pancreatitis, and surgery in acute necrotizing pancreatitis. I wondered—perhaps uncharitably—if these were thrown in as an afterthought by basic science editors to appease clinicians and endoscopists who might read this book. Let me deal with the basic science chapters first. Some of them read like a paper, with Introduction, Materials and Methods, Results, and Discussion sections. Chapter 4, entitled “Gemcitabine changes the gene expression in human pancreatic cancer cells: search for new therapeutic molecular targets” (Motoo Y, Shimasaki T, Minamoto T) is an example of this. Other chapters are more traditional review articles (eg, Chapter 5: “Cannabinoids as potential antitumoral agents in pancreatic cancer” [Velasco G, Carracedo A, Lorente M, Guzman M]). Chapter length ranges from 6 to 16 pages. There are scattered color images, as well as line drawings (some of them black and white, others incorporating welcome color). There is a fairly international author list: 4 are from Uzbekistan, 7 from Spain, 3 each from Japan and Germany, 2 from the United States, and 1 each from France and the United Kingdom. Someone has worked hard to make sure the English is of a consistently high standard, and there is minimal overlap between chapters. So, kudos to the editorial team at Springer-Verlag. The larger chapters are broken into sections to reduce the negative visual impact of large blocks of text without illustrations. The chapters are well referenced. The index is disappointingly sparse, however. No kudos for that.

In the absence of a stated aim for this book, I will take the liberty of suggesting one. For most students of the pancreas who are not bench researchers, the basic science of acute and chronic pancreatitis, and pancreatic cancer, is inaccessible. Which is a great pity! Trainees need to know something about heat shock proteins: Specifically, what they are, why they are “good” in acute pancreatitis and “bad” in pancreatic cancer, and how they will influence future therapy for these diseases. The genetics (and epigenetics) of pancreatitis and pancreatic cancer are similarly cloaked in mystery for the non-cognoscenti, despite great strides that have been made in the last 15 years. Who but a few researchers knew that cannabinoids may inhibit pancreatic cancer? And that adipose tissue is not just a passive bystander in severe acute pancreatitis, the release of free fatty acids and the lipolytic enzyme, lipase, now being incriminated in promoting the destructive cascade? There is a wealth of interesting tidbits for the trainee and practicing clinician in this little book, some of which are truly “translational.” However, some “mining” is needed to reach the gems in most of the chapters, and I fear that the current generation of medical students, residents, and fellows will lack the patience to dig deep. If there are future editions of this book—and I really hope there will be—the authors, editors, and publishers should create a format that identifies “What is known?”, “What's new?”, and “How do (or will) these findings influence clinical practice?”

Bottom Line: This is an eclectic collection of papers and short reviews on emerging research in pancreatology. Future editions will benefit from a more accessible format for clinicians. This book will likely find a place in divisional libraries and fellows' work rooms. It is too detailed for students and residents.