Acute pancreatitis.
OBJECTIVE
This review presents advances in our understanding of the pathobiologic responses of acute pancreatitis from studies using animal models of experimental pancreatitis as well as results of key clinical trials and observations.


RESULTS
The reports during the past year show significant advances in our understanding of the pathobiology of acute pancreatitis. In particular, there are findings presented that are relevant to our further understanding of pancreatic intracellular digestive enzyme activation; the pancreatic inflammatory response; and cell death responses such as necrosis as apoptosis. Other reports add to understanding of the control of microcirculatory disturbances in acute pancreatitis, and of the role of the pancreatic neural system in regulating the microcirculation as well as the pain associated with the disorder. Finally, there are clinical trials showing benefits of enteral feeding on outcome of acute pancreatitis as well as the finding that diclofenac prevents endoscopic retrograde cholangiopancreatography-induced pancreatitis.


CONCLUSIONS
Our understanding of the mechanistic processes that mediate the pathobiologic responses of pancreatitis is rapidly evolving. In addition, we now have initial evidence for potential treatment strategies for this disorder. Testing treatment strategies will lead to improved therapies and outcomes for patients with acute pancreatitis.
Pandol
Stephen J
SJ
VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, Building 258 Room 340, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA. Stephen.Pandol@med.va.gov
D000818:Animals; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D006801:Humans; D019283:Pancreatitis, Acute Necrotizing / Q000503:physiopathology* / Q000628:therapy; D051381:Rats; D014357:Trypsin / Q000378:metabolism
D014357:Trypsin