The Pancreas: An Integrated Textbook of Basic Science, Medicine, and Surgery

About the Companion Website xvii

Section 1 Anatomy of the Pancreas 1

1 Development of the Pancreas and Related Structures 3
Brian Lewis and Junhao Mao

2 Anatomy, Histology, and Fine Structure of the Pancreas 9
Daniel S. Longnecker and Elizabeth D. Thompson

3 Congenital and Inherited Anomalies of the Pancreas 23
Heiko Witt and Martin Zenker

Section 2 Physiology and Pathophysiology of Pancreatic Functions 33

4 Physiology of Acinar Cell Secretion 35
Ole H. Petersen

5 Physiology of Duct Cell Secretion 48
Wei- Yin Lin, Paramita Sarkar, and Shmuel Muallem

6 Physiology and Pathophysiology of Function of Sphincter of Oddi 56
Savio George Barreto and James Toouli

7 Neurohormonal and Hormonal Control of Pancreatic Secretion 65
Chung Owyang and Matthew J. DiMagno

8 Regulation of Pancreatic Protein Synthesis and Growth 75
Maria Dolors Sans and John A. Williams

9 Fibrogenesis in the Pancreas: The Role of Pancreatic Stellate Cells 86
Minoti V. Apte, Romano C. Pirola, and Jeremy S. Wilson

10 Pancreatic Endocrine–Exocrine Relationship 98
Kenichiro Furuyama and Yoshiya Kawaguchi

Section 3 Acute Pancreatitis 105

11 Epidemiology and Etiology of Alcohol- Induced Pancreatitis 107
Jeremy S. Wilson, Romano C. Pirola, and Minoti V. Apte

12 Epidemiology and Etiology of Biliary Acute Pancreatitis 119
Ippei Ikoma, Ko Tomishima, and Hiroyuki Isayama

13 Genetic Factors in Acute Pancreatitis 128
Mitchell L. Ramsey and Georgios I. Papachristou

14 The Role of the Intestine and Mesenteric Lymph in the Development of Organ Dysfunction in Severe Acute Pancreatitis 138
Alistair B.J. Escott, Anthony R.J. Phillips, and John A. Windsor

15 The Role of Neurogenic Inflammation in Pancreatitis 146
Metrah Mohammad Nader and Jami L. Saloman

16 Molecular, Biochemical, and Metabolic Abnormalities of Acute Pancreatitis 155
Ujjwal M. Mahajan, F. Ulrich Weiss, Markus M. Lerch, and Julia Mayerle

17 Histopathology of Acute Pancreatitis 164
Günter Klöppel

18 Severity Classification of Acute Pancreatitis 170
John A. Windsor

19 Clinical Assessment and Biochemical Markers to Objectify Severity and Prognosis 176
Bettina M. Rau and Claus Schäfer

20 Acute Pancreatitis Associated with Congenital Anomalies 185
Charlotte S. Austin, Christopher R. Schlieve, Andrew L. Warshaw, and Tracy C. Grikscheit

21 Acute Pancreatitis in Children 191
Mark E. Lowe and Véronique D. Morinville

22 Acute Pancreatitis Associated with Metabolic, Infections and Drug- Related Diseases 199
Ali A. Aghdassi, Mats L. Wiese, Quang Trung Tran, and Markus M. Lerch

23 Radiologic Diagnosis and Staging of Severe Acute Pancreatitis 208
Yoshihisa Tsuji

24 Conservative Therapy of Acute Pancreatitis: Volume Substitution and Enteral and Parenteral Nutrition 222
Steven M. Hadley, Jr. and Timothy B. Gardner

25 ICU Treatment of Severe Acute Pancreatitis 230
Scott R. Gunn and David C. Whitcomb

26 Clinical Course and Medical Treatment of Acute Pancreatitis— Use of Antibiotics in Severe Acute Pancreatitis: Indications and Limitations 238
Rainer Isenmann and Mathias Wittau

27 Indications for Interventional and Surgical Treatment of Necrotizing Pancreatitis 244
Lily V. Saadat and Thomas E. Clancy

28 Management of Infected Necrosis: Step- Up Approach 254
Hester C. Timmerhuis, Marc G. Besselink, and Hjalmar C. van Santvoort

29 Management of Infected Pancreatic Necroses: An Endoscopic Approach 260
Todd H. Baron

30 Minimally Invasive Debridement and Lavage of Necrotizing Pancreatitis 266
Kulbir Mann and Michael G.T. Raraty

31 Open Surgical Debridement of Necrotizing Pancreatitis: Late Postoperative Morbidity and Outcome 271
Dongya Huang, Zipeng Lu, and Yi Miao

32 Endoscopic Treatment of Acute Biliary Pancreatitis 278
Ichiro Yasuda, Tsuyoshi Mukai, and Toru Ito

33 Strategies for the Treatment of Pancreatic Pseudocysts and Walled- Off Necrosis After Acute Pancreatitis: Interventional Endoscopic Approaches 284
Georg Beyer and Julia Mayerle

34 Pseudocysts and Walled- Off Necrosis After Acute Pancreatitis: Surgical Approach 288
Naohiro Sata, Masaru Koizumi, and Alan Kawarai Lefor

35 Management of Fluid Collection in Acute Pancreatitis 294
Georg Beyer, Simon Sirtl, Christoph Ammer- Herrmenau, and Albrecht Neesse

36 Management of Pancreatic Fistula in Acute Pancreatitis 300
Marta Sandini, Thilo Hackert, and Markus W. Büchler

37 Long- Term Outcome After Acute Pancreatitis 306
Christin Tjaden and Thilo Hackert

Section 4 Chronic Pancreatitis 315

38 Definition and Classification of Chronic Pancreatitis 317
David C. Whitcomb

39 Molecular Understanding of Chronic Pancreatitis 326
Bomi Lee, Monique T. Barakat, and Sohail Z. Husain

40 Natural History of Recurrent Acute and Chronic Pancreatitis 334
Rohit Das, Jorge D. Machicado, and Dhiraj Yadav

41 Pediatric Recurrent Acute and Chronic Pancreatitis: Role of Pancreas Divisum 344
Jiri Snajdauf, Michal Rygl, Barbora Kucerova, and Natalia Newland

42 Clinical and Laboratory Diagnosis of Chronic Pancreatitis 349
Georg Beyer, Markus M. Lerch, and Julia Mayerle

43 Abdominal Imaging for the Diagnosis of Chronic Pancreatitis 357
Atsushi Irisawa and Akira Yamamiya

44 Endoscopic Ultrasound for Diagnosis of Chronic Pancreatitis Versus Pancreatic Cancer 366
J. Enrique Domínguez- Munoz, Julio Iglesias- García, José Larino- Noia, and Daniel de la Iglesia- García

45 Hereditary Pancreatitis and Complex Genetic Causes 375
Celeste Shelton Ohlsen and David C. Whitcomb

46 Epidemiology and Pathophysiology of Tropical Chronic Pancreatitis 383
Shailesh V. Shrikhande and Savio G. Barreto

47 CFTR- Associated Pancreatic Disease 390
Chee Y. Ooi and Aliye Uc

48 Alcohol and Smoking in Chronic Pancreatitis 396
Atsushi Masamune, Kazuhiro Kikuta, and Kiyoshi Kume

49 Idiopathic and Rare Causes of Chronic Pancreatitis 404
Morihisa Hirota and Tooru Shimosegawa

50 Early Chronic Pancreatitis 412
Kazuhiro Kikuta and Atsushi Masamune

51 Chronic Pancreatitis with Inflammatory Mass in the Pancreatic Head 418
Ulrich F. Wellner, Kim C. Honselmann, and Tobias Keck

52 Structural Complications: Strictures, Stones, Pseudocysts, and Vascular Complications 424
Xiaodong Tian, Xiaochao Guo, and Yinmo Yang

53 Nutritional Evaluation and Support: An Overview 430
Sinead N. Duggan and Stephen J. O’Keefe

54 Exocrine Pancreatic Insufficiency 436
Chris E. Forsmark

55 Bone Disease in Chronic Pancreatitis 442
Sinead N. Duggan

56 Diabetes from Exocrine Pancreatic Disease 445
Nao Fujimori, Tetsuhide Ito, and Yoshihiro Ogawa

57 Oxidative Stress and Antioxidants in Chronic Pancreatitis 451
Soumya Jagannath Mahapatra and Pramod Kumar Garg

58 Pain Mechanisms in Chronic Pancreatitis 460
Pierluigi Di Sebastiano, Fabio Francesco di Mola, Tommaso Grottola, and Rossana Percario

59 Pain Management in Chronic Pancreatitis 467
Louise Kuhlmann, Soren S. Olesen, and Asbjorn M. Drewes

60 Adjunctive Therapy in Chronic Pancreatitis 474
Anna Evans Phillips

61 Pancreatic Cancer Risks in Chronic Pancreatitis 480
Patrick Maisonneuve and Albert B. Lowenfels

62 Evidence of Endoscopic and Interventional Treatment of Chronic Pancreatitis and Pseudocysts 486
Jörg Schirra, Simon Sirtl MD, Markus M. Lerch, and Julia Mayerle

63 Major Pancreatic Resection for Chronic Pancreatitis: Indication, Goals, and Limitations 496
Faik G. Uzunoglu and Jakob R. Izbicki

64 Pancreatic Drainage Procedures: Techniques and Results 501
Ulrich F. Wellner, Dirk Bausch, and Tobias Keck

65 Duodenum- Preserving Pancreatic Head Resections for Chronic Pancreatitis: Techniques and Results 506
Hans G. Beger, Bertram Poch, Yang Yinmo, and Waldemar Uhl

66 Total Pancreatectomy with Islet Autotransplant 515
Greg Beilman, Zachary Bergman, and Melena Bellin

67 Minimally Invasive Surgical Management of Chronic Pancreatitis 523
Gilbert Z. Murimwa, Herbert J. Zeh III, and Matthew R. Porembka

Section 5 Autoimmune Pancreatitis 533

68 Epidemiology of Autoimmune Pancreatitis 535
Terumi Kamisawa

69 Molecular Immunology and Pathogenesis of Autoimmune Pancreatitis 540
Yoh Zen

70 Clinical Manifestation of Type 1 Autoimmune Pancreatitis 546
Tooru Shimosegawa

71 Clinical Manifestation of Type 2 Autoimmune Pancreatitis 554
Nicolo de Pretis and Luca Frulloni

72 Clinical Diagnostic Criteria for Autoimmune Pancreatitis 561
Tooru Shimosegawa

73 Laboratory Diagnosis of Autoimmune Pancreatitis 568
J- Matthias Löhr and Miroslav Vujasinovic

74 What is the Evidence Measuring Immune Markers 573
Shigeyuki Kawa, Takayuki Watanabe, and Norihiro Ashihara

75 Autoimmune Pancreatitis and IgG4- Related Disease 579
Kazuichi Okazaki, Tsukasa Ikeura, and Kazushige Uchida

76 Imaging Diagnosis of Autoimmune Pancreatitis 595
Kazuichi Okazaki, Makoto Takaoka, Tsukasa Ikeura, and Kazushige Uchida

77 Medical Management of Autoimmune Pancreatitis 600
Shounak Majumder and Suresh T. Chari

78 Management of Intractable Autoimmune Pancreatitis 605
Shounak Majumder and Suresh T. Chari

79 Long- Term Outcome After Treatment of Autoimmune Pancreatitis 609
Luca Frulloni and Nicolo de Pretis

Section 6 Neoplastic Tumors of the Exocrine Tissue: Benign Cystic Neoplasms of the Pancreas 615

80 Epidemiology of Cystic Neoplasms of the Pancreas 617
Shounak Majumder and Suresh T. Chari

81 Histologic Classification and Staging of Cystic Neoplasms 623
Noriyoshi Fukushima and Giuseppe Zamboni

82 Molecular Mechanisms of Cystic Neoplasia- 630
Nickolas Papadopoulos and Ralph H. Hruban

83 Clinical Presentation of Pancreatic Cystic Neoplasms 638
Masao Tanaka

84 Evaluation of Cystic Lesions Using EUS, MRI, and CT 642
Anne Marie Lennon and Atif Zaheer

85 Cytologic Evaluation of Cystic Neoplasms: The Role of Liquid Biopsy 652
Abdulwahab Ewaz and Michelle D. Reid

86 Natural History of Cystic Neoplasms: IPMN, MCN, SCN, and SPN 666
Rosa Klotz, Thilo Hackert, and Markus W. Büchler

87 Surveillance or Surgical Treatment in Asymptomatic Cystic Neoplasm 674
Klaus Sahora and Carlos Fernández- del Castillo

88 Artificial Intelligence in the Detection and Surveillance of Cystic Neoplasms 680
Linda C. Chu and Elliot K. Fishman

89 Oncologic Resection of IPMN and MCN: Open Approach?Results 688
Marco Del Chiaro, Michael J. Kirsch, and Richard D. Schulick

90 Surgical Treatment of Cystic Neoplasms: Laparoscopic and Robotic Approach—Results 693
Benedict Kinny- Köster, Christopher L. Wolfgang, Markus W. Büchler, and Thilo Hackert

91 Robotic- assisted Resection of Cystic Neoplasms 700
Kimberly Kopecky and Jin He

92 Duodenum- preserving Pancreatic Head Resection for Cystic Neoplasms of the Pancreatic Head: Indications and Limitations 709
Hans G. Beger and Bertram Poch

93 Pancreatic Middle Segment Resection of Cystic Neoplasms: Indications and Limitations 715
Calogero Iacono and Mario De Bellis

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94 Tumor Enucleation for Cystic Neoplasms of the Pancreas: Indications and Limitations 723
Rachel C. Kim, C. Max Schmidt, and Henry A. Pitt

95 Duodenum- preserving Pancreatic Head Resection and Local Extirpation of SPTP in Children and Adolescents: Indications and long- term results 732
Jiri Snajdauf, Michal Rygl, Barbora Kucerova, and Natalia Newland

96 Management of Recurrence of Cystic Neoplasms 737
Anna Nießen, Christopher L. Wolfgang, Thilo Hackert, and Markus W. Büchler

97 Long- term Outcome after Observation and Surgical Treatment of Cystic Neoplasms: What is the Evidence? 744
Roberto Salvia, Giovanni Marchegiani, Giampaolo Perri, and Claudio Bassi

Section 7 Neoplastic Tumors of the Endocrine Pancreas: Neuroendocrine Tumors of the Pancreas 751

98 Epidemiology and Classification of Neuroendocrine Tumors of the Pancreas 753
J.J. Mukherjee, K.O. Lee, and Gregory Kaltsas

99 Pathology of Neuroendocrine Neoplasms 763
Atsuko Kasajima and Hironobu Sasano

100 Molecular Genetics of Neuroendocrine Tumors 771
Nickolas Papadopoulos and Ralph H. Hruban

101 What is the Origin of Pancreatic Endocrine Tumors? 781
Aurel Perren, Iacovos P. Michael, and Ilaria Marinoni

102 Clinical Manifestation of Endocrine Tumors of the Pancreas 791
Tetsuhide Ito, Keijiro Ueda, Nao Fujimori, and Robert T. Jensen

103 Evidence of Hormonal, Laboratory, Biochemical, and Instrumental Diagnostics of Neuroendocrine Tumors of the Pancreas 799
K.O. Lee, Gregory Kaltsas, and J.J. Mukherjee

104 Pancreatic Neuroendocrine Tumors in Multiple Neoplasia Syndromes 808
Anja Rinke and Thomas Matthias Gress

105 Nonfunctioning Pancreatic Neuroendocrine Neoplasms: Diagnosis and Management Principles 815
Takao Ohtsuka, Yuto Hozaka, and Hiroshi Kurahara

106 Medical and Nucleotide Treatment of Neuroendocrine Tumors of the Pancreas 820
Marina Tsoli and Gregory Kaltsas

107 Interventional Radiology in the Treatment of Pancreatic Neuroendocrine Tumors 829
Tetsuya Idichi, Hiroshi Kurahara, and Takao Ohtsuka

108 Enucleation of Benign, Neuroendocrine Tumors of the Pancreas 833
Frank Weber, Andreas Machens, and Henning Dralle

109 Duodenum- Preserving Pancreatic Head Resection or Local Extirpation of Neuroendocrine Tumors of the Pancreas Larger than 2 cm 841
Takashi Hatori

110 Individualized Surgery for Nonfunctional Pancreatic Neuroendocrine Tumors (NF- pNET) <2 cm: Indication, Surgical Principles, and Long- term Outcome 849
Charles de Ponthaud, Julien de Martino, and Sébastien Gaujoux

111 Surgical Treatment of Endocrine Tumors: Major Oncologic Resection 857
Frank Weber, Andreas Machens, and Henning Dralle

112 The Management of Insulinoma 865
Keijiro Ueda, Nao Fujimori, Robert T. Jensen, and Tetsuhide Ito

113 Evidence of Medical and Surgical Treatment of Gastrinoma 872
Ryuichiro Doi

114 Rare Neuroendocrine Tumors of Pancreas: Management and Evidence of Surgical Treatment 876
Ryuichiro Doi

115 Treatment of Neuroendocrine Neoplasia of the Pancreas and Biliary Tract 882
Andrea Frilling, Ashley K. Clift, and Vito Cicinnati

116 Survival after Treatment of Endocrine Tumors 891
Zhe Cao and Taiping Zhang

Section 8 Neoplastic Tumors of Exocrine Tissue: Pancreatic Cancer 897

117 Epidemiology of Pancreatic Cancer 899
Evelina Mocci and Alison P. Klein

118 Smoking, a Risk for Pancreatic Cancer: Experimental and Clinical Data 905
Uwe A. Wittel, Bradley R. Hall, and Surinder K. Batra

119 Molecular Understanding of the Development of Ductal Pancreatic Cancer 912
Jae W. Lee, Ralph H. Hruban, and Laura D. Wood

120 From Tissue Turnover to the Cell of Origin of Pancreatic Cancer: An Updated View 921
Bo Kong, Eva Thoma, and Christoph W. Michalski

121 Microbiome of Pancreatic Cancer: Involvement in Cancer Development and Chemo- /Immunotherapy 928
Xianjun Yu

122 Molecular Subtypes and Clinical Applications 934
Maarten F. Bijlsma and Peter Bailey

123 Tumor Microenvironment: Immune Cells and Immunosuppressive Functions of Carcinoma- associated Fibroblasts and Macrophages 942
Tony Pang, Zhihong Xu, Chamini Perera, and Minoti V. Apte

124 Familial Pancreatic Cancer 951
Alison P. Klein

125 Pathology of Exocrine Pancreatic Tumors 957
Meredith E. Pittman and Ralph H. Hruban

126 Pancreatic Cancer: Precancerous Lesions 969
Michael J. Pflüger, Michaël Noë, and Lodewijk A.A. Brosens

127 Clinical History and Risk Factors of Pancreatic Cancer 982
Norbert Hüser, Volker Aßfalg, and Helmut Friess

128 The Role of Endoscopic Ultrasonography in the Diagnosis and Differential Diagnosis of Neoplastic Lesions 989
Yoshiki Hirooka, Senju Hashimoto, and Eizaburo Ohno

129 Radiologic Diagnosis of Pancreatic Cancer: CT, MRI 997
Hannah S. Recht and Elliot K. Fishman

130 Screening of Hereditary Pancreatic Cancer 1012
Michael Goggins

131 The Role of PET in Diagnosis of Pancreatic Cancer and Cancer Recurrence 1021
Norbert Hüser, Volker Aßfalg, Isabel Rauscher, and Helmut Friess

132 Tumor Markers in Pancreatic Malignancies 1028
Shin Hamada and Atsushi Masamune

133 The Role of Laparoscopy and Peritoneal Cytology in the Management of Pancreatic Cancer 1033
Yosuke Kasai, Kyoichi Takaori, and Etsuro Hatano

134 Clinical Assessment and Staging of Advanced Pancreatic Cancer 1037
James M. Lindberg, Giles F. Whalen, and Jennifer LaFemina

135 Pancreatic Cancer: Indications for Resection 1047
Akimasa Nakao and Suguru Yamada

136 Pancreatoduodenectomy for Pancreatic Cancer: Short- and Long- term Outcome after Kausch- Whipple and Pylorus- preserving Pancreatoduodenectomy 1055
Benedict Kinny- Köster, John L. Cameron, and Jin He

137 Left Pancreatectomy for Body and Tail Cancer 1063
Jony van Hilst, Mohammad Abu Hilal, and Marc G Besselink

138 Total Pancreatectomy: Indications and Limitations 1071
Seiko Hirono and Hiroki Yamaue

139 Minimally Invasive Resection for Pancreatic Cancer 1078
Patricio M. Polanco, Imad Radi, and Herbert J. Zeh iii

140 Robotic Resection for Pancreatic Cancer 1093
Renyi Qin

141 Extended Radical Surgery for Pancreatic Cancer 1099
Thilo Hackert, Anna Nießen, and Markus W. Büchler

142 Palliative Pancreatic Resection: Is It Justified? 1108
Kira C. Steinkraus, Max Heckler, Christoph W. Michalski, and Felix J. Hüttner

143 Outcome of Patients after R0 Resection for Locally Advanced Pancreatic Cancer Combined with Hepatic Metastasectomy: Indications and Limitations 1113
Tingbo Liang

144 Bypass Surgery for Advanced Pancreatic Cancer 1117
Eva Thoma, Thilo Hackert, Christoph W. Michalski, and Felix J. Hüttner

145 Endoscopic and Interventional Palliation of Pancreatic Cancer 1122
Kazumasa Nagai and Takao Itoi

146 Neoadjuvant Treatment of Pancreatic Cancer: Evidence for Treatment Effect 1131
Robert A. Wolff

147 Locally Advanced Pancreatic Cancer: Does the Addition of Stereotactic Body Radiation Therapy to Neoadjuvant Chemotherapy Lead to a Significant Survival Improvement after R0 Resection? 1141
Marco Del Chiaro, Michael J. Kirsch, and Richard D. Schulick

148 Adjuvant Chemotherapy in Pancreatic Cancer: First Line and Second Line Treatment— Benefits of Survival 1143
Kulbir Mann, Robert P. Jones, Paula Ghaneh, and John P. Neoptolemos

149 Role of Radiation Therapy for Pancreatic Cancer 1153
Baho U. Sidiqi, Abhinav V. Reddy, Joseph M. Herman, and Amol K. Narang

150 Immunotherapy for Pancreatic Cancer: Checkpoint Blockade and Vaccine Therapy 1164
Arsen Osipov, Adrian G. Murphy, and Lei Zheng

151 Targeted Therapies for Pancreatic Cancer 1180
Anirban Maitra

152 Precision Cancer Medicine 1188
Grace Oh, Surajit Dhara, and Diane Simeone

153 Palliative Chemotherapy for Advanced Pancreatic Cancer: Treatment Modalities, Side- effects, and Benefits of Survival 1196
Christoph Springfeld and Thomas Seufferlein

154 Management of Pain in Pancreatic Cancer 1201
Annie W. Hsu, Ayodeji Omosule, and Michael Erdek

155 Management of Cancer Recurrence 1208
Oliver Strobel, Martin Loos, and Markus W. Büchler

156 Survival and Late Morbidity after Resection of Pancreatic Cancer 1218
Avinoam Nevler and Charles J. Yeo

Section 9 Periampullary Cancers and Tumors Other Than Pancreatic Cancer 1233

157 Periampullary Tumors: Clinical Presentation and Diagnostic Strategies 1235
Jon M. Harrison and Keith D. Lillemoe

158 Histology and Genetics of Cancer of the Papilla, Distal Common Bile Duct, and Duodenum 1242
Yue Xue, Michelle D. Reid, and Volkan Adsay

159 Adenoma and Adenocarcinoma of the Ampulla of Vater: Diagnosis and Management 1254
Sahin Coban, Omer Basar, and William R. Brugge

160 Endoscopic Treatment of Adenomas of the Ampulla of Vater: Techniques, Results, Benefits, and Limitations 1264
Natsuyo Yamamoto and Hiroyuki Isayama

161 Surgical Treatment of Papillary and Ampullary Tumors: Management and Long- term Results 1272
Norbert Hüser, Volker Aßfalg, and Helmut Friess

162 Surgical Treatment of Duodenal Cancer 1281
Fuyuhiko Motoi

163 Surgical Treatment of Distal Cholangiocarcinoma 1284
Shunsuke Onoe, Yukihiro Yokoyama, and Tomoki Ebata

164 Adjuvant and Palliative Chemotherapy of Periampullary Cancers 1291
Arachchige D.N.R. Ponweera, Paula Ghaneh, and John P. Neoptolemos

165 Long- term Survival After Resection of Periampullary Cancer 1299
Hideyuki Yoshitomi, Masayuki Ohtsuka, and Masaru Miyazaki

Section 10 Transplantation of the Pancreas 1309

166 Transplantation of Pancreatic Islets 1311
Joseph Sushil Rao, Melena D. Bellin, and Bernhard J. Hering

167 Transplantation of the Pancreas 1323
Rainer W.G. Gruessner and Angelika C. Gruessner

Index 1333