Pancreas

Hans G. Beger, MD, FACS (Hon.), JSS (Hon.), CSS (Hon.), Professor Emeritus of Surgery, University of Ulm, Ulm, Germany. Markus W. Büchler, MD, FACS (Hon.), FRCS (Hon.), FASA (Hon.) Professor of Surgery, University of Heidelberg, Heidelberg, Germany. Ralph H. Hruban, MD, Baxley Professor and Director, Department of Pathology and Director of the Sol Goldman Pancreatic Research Center, Johns Hopkins University School of Medicine, Baltimore, USA. Julia Mayerle, MD, Professor of Internal Medicine, Gastroenterology and Hepatology, Chair Department of Medicine II, LMU Klinikum, Ludwig-Maximilians-University, Munich, Germany. John P. Neoptolemos, MA, MB, BCHIR, MD FRCS, FMEDSCI, MAE Professor of Surgery, Department of Surgery, University of Heidelberg, Heidelberg, Germany. Tooru Shimosegawa, MD, PhD, Professor Emeritus Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. Andrew L. Warshaw, MD, FACS, FRCSEd (Hon.), W. Gerald Austen Distinguished Professor of Surgery, Harvard Medical School, and Surgeon-in-Chief Emeritus, Massachusetts General Hospital, Boston, USA. David C. Whitcomb, MD, PhD, Professor of Medicine, Cell Biology & Physiology, and Human Genetics, Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh and UPMC, Pennsylvania, USA. Yupei Zhao, MD, FICS (Hon.), FACS (Hon.), FRCS (Engl) (Hon.), FCSHK (Hon.), Professor of Surgery, Department of General Surgery, Peking Union Medical College Hospital, Beijing, P.R. China.

• About the Companion Website xviiSection 1 Anatomy of the Pancreas 11 Development of the Pancreas and Related Structures 3Brian Lewis and Junhao Mao2 Anatomy, Histology, and Fine Structure of the Pancreas 9Daniel S. Longnecker and Elizabeth D. Thompson3 Congenital and Inherited Anomalies of the Pancreas 23Heiko Witt and Martin ZenkerSection 2 Physiology and Pathophysiology of Pancreatic Functions 334 Physiology of Acinar Cell Secretion 35Ole H. Petersen5 Physiology of Duct Cell Secretion 48Wei- Yin Lin, Paramita Sarkar, and Shmuel Muallem6 Physiology and Pathophysiology of Function of Sphincter of Oddi 56Savio George Barreto and James Toouli7 Neurohormonal and Hormonal Control of Pancreatic Secretion 65Chung Owyang and Matthew J. DiMagno8 Regulation of Pancreatic Protein Synthesis and Growth 75Maria Dolors Sans and John A. Williams9 Fibrogenesis in the Pancreas: The Role of Pancreatic Stellate Cells 86Minoti V. Apte, Romano C. Pirola, and Jeremy S. Wilson10 Pancreatic Endocrine–Exocrine Relationship 98Kenichiro Furuyama and Yoshiya KawaguchiSection 3 Acute Pancreatitis 10511 Epidemiology and Etiology of Alcohol- Induced Pancreatitis 107Jeremy S. Wilson, Romano C. Pirola, and Minoti V. Apte12 Epidemiology and Etiology of Biliary Acute Pancreatitis 119Ippei Ikoma, Ko Tomishima, and Hiroyuki Isayama13 Genetic Factors in Acute Pancreatitis 128Mitchell L. Ramsey and Georgios I. Papachristou14 The Role of the Intestine and Mesenteric Lymph in the Development of Organ Dysfunction in Severe Acute Pancreatitis 138Alistair B.J. Escott, Anthony R.J. Phillips, and John A. Windsor15 The Role of Neurogenic Inflammation in Pancreatitis 146Metrah Mohammad Nader and Jami L. Saloman16 Molecular, Biochemical, and Metabolic Abnormalities of Acute Pancreatitis 155Ujjwal M. Mahajan, F. Ulrich Weiss, Markus M. Lerch, and Julia Mayerle17 Histopathology of Acute Pancreatitis 164Günter Klöppel18 Severity Classification of Acute Pancreatitis 170John A. Windsor19 Clinical Assessment and Biochemical Markers to Objectify Severity and Prognosis 176Bettina M. Rau and Claus Schäfer20 Acute Pancreatitis Associated with Congenital Anomalies 185Charlotte S. Austin, Christopher R. Schlieve, Andrew L. Warshaw, and Tracy C. Grikscheit21 Acute Pancreatitis in Children 191Mark E. Lowe and Véronique D. Morinville22 Acute Pancreatitis Associated with Metabolic, Infections and Drug- Related Diseases 199Ali A. Aghdassi, Mats L. Wiese, Quang Trung Tran, and Markus M. Lerch23 Radiologic Diagnosis and Staging of Severe Acute Pancreatitis 208Yoshihisa Tsuji24 Conservative Therapy of Acute Pancreatitis: Volume Substitution and Enteral and Parenteral Nutrition 222Steven M. Hadley, Jr. and Timothy B. Gardner25 ICU Treatment of Severe Acute Pancreatitis 230Scott R. Gunn and David C. Whitcomb26 Clinical Course and Medical Treatment of Acute Pancreatitis— Use of Antibiotics in Severe Acute Pancreatitis: Indications and Limitations 238Rainer Isenmann and Mathias Wittau27 Indications for Interventional and Surgical Treatment of Necrotizing Pancreatitis 244Lily V. Saadat and Thomas E. Clancy28 Management of Infected Necrosis: Step- Up Approach 254Hester C. Timmerhuis, Marc G. Besselink, and Hjalmar C. van Santvoort29 Management of Infected Pancreatic Necroses: An Endoscopic Approach 260Todd H. Baron30 Minimally Invasive Debridement and Lavage of Necrotizing Pancreatitis 266Kulbir Mann and Michael G.T. Raraty31 Open Surgical Debridement of Necrotizing Pancreatitis: Late Postoperative Morbidity and Outcome 271Dongya Huang, Zipeng Lu, and Yi Miao32 Endoscopic Treatment of Acute Biliary Pancreatitis 278Ichiro Yasuda, Tsuyoshi Mukai, and Toru Ito33 Strategies for the Treatment of Pancreatic Pseudocysts and Walled- Off Necrosis After Acute Pancreatitis: Interventional Endoscopic Approaches 284Georg Beyer and Julia Mayerle34 Pseudocysts and Walled- Off Necrosis After Acute Pancreatitis: Surgical Approach 288Naohiro Sata, Masaru Koizumi, and Alan Kawarai Lefor35 Management of Fluid Collection in Acute Pancreatitis 294Georg Beyer, Simon Sirtl, Christoph Ammer- Herrmenau, and Albrecht Neesse36 Management of Pancreatic Fistula in Acute Pancreatitis 300Marta Sandini, Thilo Hackert, and Markus W. Büchler37 Long- Term Outcome After Acute Pancreatitis 306Christin Tjaden and Thilo HackertSection 4 Chronic Pancreatitis 31538 Definition and Classification of Chronic Pancreatitis 317David C. Whitcomb39 Molecular Understanding of Chronic Pancreatitis 326Bomi Lee, Monique T. Barakat, and Sohail Z. Husain40 Natural History of Recurrent Acute and Chronic Pancreatitis 334Rohit Das, Jorge D. Machicado, and Dhiraj Yadav41 Pediatric Recurrent Acute and Chronic Pancreatitis: Role of Pancreas Divisum 344Jiri Snajdauf, Michal Rygl, Barbora Kucerova, and Natalia Newland42 Clinical and Laboratory Diagnosis of Chronic Pancreatitis 349Georg Beyer, Markus M. Lerch, and Julia Mayerle43 Abdominal Imaging for the Diagnosis of Chronic Pancreatitis 357Atsushi Irisawa and Akira Yamamiya44 Endoscopic Ultrasound for Diagnosis of Chronic Pancreatitis Versus Pancreatic Cancer 366J. Enrique Domínguez- Muñoz, Julio Iglesias- García, José Lariño- Noia, and Daniel de la Iglesia- García45 Hereditary Pancreatitis and Complex Genetic Causes 375Celeste Shelton Ohlsen and David C. Whitcomb46 Epidemiology and Pathophysiology of Tropical Chronic Pancreatitis 383Shailesh V. Shrikhande and Savio G. Barreto47 CFTR- Associated Pancreatic Disease 390Chee Y. Ooi and Aliye Uc48 Alcohol and Smoking in Chronic Pancreatitis 396Atsushi Masamune, Kazuhiro Kikuta, and Kiyoshi Kume49 Idiopathic and Rare Causes of Chronic Pancreatitis 404Morihisa Hirota and Tooru Shimosegawa50 Early Chronic Pancreatitis 412Kazuhiro Kikuta and Atsushi Masamune51 Chronic Pancreatitis with Inflammatory Mass in the Pancreatic Head 418Ulrich F. Wellner, Kim C. Honselmann, and Tobias Keck52 Structural Complications: Strictures, Stones, Pseudocysts, and Vascular Complications 424Xiaodong Tian, Xiaochao Guo, and Yinmo Yang53 Nutritional Evaluation and Support: An Overview 430Sinead N. Duggan and Stephen J. O’Keefe54 Exocrine Pancreatic Insufficiency 436Chris E. Forsmark55 Bone Disease in Chronic Pancreatitis 442Sinead N. Duggan56 Diabetes from Exocrine Pancreatic Disease 445Nao Fujimori, Tetsuhide Ito, and Yoshihiro Ogawa57 Oxidative Stress and Antioxidants in Chronic Pancreatitis 451Soumya Jagannath Mahapatra and Pramod Kumar Garg58 Pain Mechanisms in Chronic Pancreatitis 460Pierluigi Di Sebastiano, Fabio Francesco di Mola, Tommaso Grottola, and Rossana Percario59 Pain Management in Chronic Pancreatitis 467Louise Kuhlmann, Søren S. Olesen, and Asbjørn M. Drewes60 Adjunctive Therapy in Chronic Pancreatitis 474Anna Evans Phillips61 Pancreatic Cancer Risks in Chronic Pancreatitis 480Patrick Maisonneuve and Albert B. Lowenfels62 Evidence of Endoscopic and Interventional Treatment of Chronic Pancreatitis and Pseudocysts 486Jörg Schirra, Simon Sirtl MD, Markus M. Lerch, and Julia Mayerle63 Major Pancreatic Resection for Chronic Pancreatitis: Indication, Goals, and Limitations 496Faik G. Uzunoglu and Jakob R. Izbicki64 Pancreatic Drainage Procedures: Techniques and Results 501Ulrich F. Wellner, Dirk Bausch, and Tobias Keck65 Duodenum- Preserving Pancreatic Head Resections for Chronic Pancreatitis: Techniques and Results 506Hans G. Beger, Bertram Poch, Yang Yinmo, and Waldemar Uhl66 Total Pancreatectomy with Islet Autotransplant 515Greg Beilman, Zachary Bergman, and Melena Bellin67 Minimally Invasive Surgical Management of Chronic Pancreatitis 523Gilbert Z. Murimwa, Herbert J. Zeh III, and Matthew R. PorembkaSection 5 Autoimmune Pancreatitis 53368 Epidemiology of Autoimmune Pancreatitis 535Terumi Kamisawa69 Molecular Immunology and Pathogenesis of Autoimmune Pancreatitis 540Yoh Zen70 Clinical Manifestation of Type 1 Autoimmune Pancreatitis 546Tooru Shimosegawa71 Clinical Manifestation of Type 2 Autoimmune Pancreatitis 554Nicolò de Pretis and Luca Frulloni72 Clinical Diagnostic Criteria for Autoimmune Pancreatitis 561Tooru Shimosegawa73 Laboratory Diagnosis of Autoimmune Pancreatitis 568J- Matthias Löhr and Miroslav Vujasinovic74 What is the Evidence Measuring Immune Markers 573Shigeyuki Kawa, Takayuki Watanabe, and Norihiro Ashihara75 Autoimmune Pancreatitis and IgG4- Related Disease 579Kazuichi Okazaki, Tsukasa Ikeura, and Kazushige Uchida76 Imaging Diagnosis of Autoimmune Pancreatitis 595Kazuichi Okazaki, Makoto Takaoka, Tsukasa Ikeura, and Kazushige Uchida77 Medical Management of Autoimmune Pancreatitis 600Shounak Majumder and Suresh T. Chari78 Management of Intractable Autoimmune Pancreatitis 605Shounak Majumder and Suresh T. Chari79 Long- Term Outcome After Treatment of Autoimmune Pancreatitis 609Luca Frulloni and Nicolò de PretisSection 6 Neoplastic Tumors of the Exocrine Tissue: Benign Cystic Neoplasms of the Pancreas 61580 Epidemiology of Cystic Neoplasms of the Pancreas 617Shounak Majumder and Suresh T. Chari81 Histologic Classification and Staging of Cystic Neoplasms 623Noriyoshi Fukushima and Giuseppe Zamboni82 Molecular Mechanisms of Cystic Neoplasia- 630Nickolas Papadopoulos and Ralph H. Hruban83 Clinical Presentation of Pancreatic Cystic Neoplasms 638Masao Tanaka84 Evaluation of Cystic Lesions Using EUS, MRI, and CT 642Anne Marie Lennon and Atif Zaheer85 Cytologic Evaluation of Cystic Neoplasms: The Role of Liquid Biopsy 652Abdulwahab Ewaz and Michelle D. Reid86 Natural History of Cystic Neoplasms: IPMN, MCN, SCN, and SPN 666Rosa Klotz, Thilo Hackert, and Markus W. Büchler87 Surveillance or Surgical Treatment in Asymptomatic Cystic Neoplasm 674Klaus Sahora and Carlos Fernández- del Castillo88 Artificial Intelligence in the Detection and Surveillance of Cystic Neoplasms 680Linda C. Chu and Elliot K. Fishman89 Oncologic Resection of IPMN and MCN: Open Approach―Results 688Marco Del Chiaro, Michael J. Kirsch, and Richard D. Schulick90 Surgical Treatment of Cystic Neoplasms: Laparoscopic and Robotic Approach—Results 693Benedict Kinny- Köster, Christopher L. Wolfgang, Markus W. Büchler, and Thilo Hackert91 Robotic- assisted Resection of Cystic Neoplasms 700Kimberly Kopecky and Jin He92 Duodenum- preserving Pancreatic Head Resection for Cystic Neoplasms of the Pancreatic Head: Indications and Limitations 709Hans G. Beger and Bertram Poch93 Pancreatic Middle Segment Resection of Cystic Neoplasms: Indications and Limitations 715Calogero Iacono and Mario De Bellis0005474686.indd 11 05-25-2023 11:30:3194 Tumor Enucleation for Cystic Neoplasms of the Pancreas: Indications and Limitations 723Rachel C. Kim, C. Max Schmidt, and Henry A. Pitt95 Duodenum- preserving Pancreatic Head Resection and Local Extirpation of SPTP in Children and Adolescents: Indications and long- term results 732Jiri Snajdauf, Michal Rygl, Barbora Kucerova, and Natalia Newland96 Management of Recurrence of Cystic Neoplasms 737Anna Nießen, Christopher L. Wolfgang, Thilo Hackert, and Markus W. Büchler97 Long- term Outcome after Observation and Surgical Treatment of Cystic Neoplasms: What is the Evidence? 744Roberto Salvia, Giovanni Marchegiani, Giampaolo Perri, and Claudio BassiSection 7 Neoplastic Tumors of the Endocrine Pancreas: Neuroendocrine Tumors of the Pancreas 75198 Epidemiology and Classification of Neuroendocrine Tumors of the Pancreas 753J.J. Mukherjee, K.O. Lee, and Gregory Kaltsas99 Pathology of Neuroendocrine Neoplasms 763Atsuko Kasajima and Hironobu Sasano100 Molecular Genetics of Neuroendocrine Tumors 771Nickolas Papadopoulos and Ralph H. Hruban101 What is the Origin of Pancreatic Endocrine Tumors? 781Aurel Perren, Iacovos P. Michael, and Ilaria Marinoni102 Clinical Manifestation of Endocrine Tumors of the Pancreas 791Tetsuhide Ito, Keijiro Ueda, Nao Fujimori, and Robert T. Jensen103 Evidence of Hormonal, Laboratory, Biochemical, and Instrumental Diagnostics of Neuroendocrine Tumors of the Pancreas 799K.O. Lee, Gregory Kaltsas, and J.J. Mukherjee104 Pancreatic Neuroendocrine Tumors in Multiple Neoplasia Syndromes 808Anja Rinke and Thomas Matthias Gress105 Nonfunctioning Pancreatic Neuroendocrine Neoplasms: Diagnosis and Management Principles 815Takao Ohtsuka, Yuto Hozaka, and Hiroshi Kurahara106 Medical and Nucleotide Treatment of Neuroendocrine Tumors of the Pancreas 820Marina Tsoli and Gregory Kaltsas107 Interventional Radiology in the Treatment of Pancreatic Neuroendocrine Tumors 829Tetsuya Idichi, Hiroshi Kurahara, and Takao Ohtsuka108 Enucleation of Benign, Neuroendocrine Tumors of the Pancreas 833Frank Weber, Andreas Machens, and Henning Dralle109 Duodenum- Preserving Pancreatic Head Resection or Local Extirpation of Neuroendocrine Tumors of the Pancreas Larger than 2 cm 841Takashi Hatori110 Individualized Surgery for Nonfunctional Pancreatic Neuroendocrine Tumors (NF- pNET) <2 cm: Indication, Surgical Principles, and Long- term Outcome 849Charles de Ponthaud, Julien de Martino, and Sébastien Gaujoux111 Surgical Treatment of Endocrine Tumors: Major Oncologic Resection 857Frank Weber, Andreas Machens, and Henning Dralle112 The Management of Insulinoma 865Keijiro Ueda, Nao Fujimori, Robert T. Jensen, and Tetsuhide Ito113 Evidence of Medical and Surgical Treatment of Gastrinoma 872Ryuichiro Doi114 Rare Neuroendocrine Tumors of Pancreas: Management and Evidence of Surgical Treatment 876Ryuichiro Doi115 Treatment of Neuroendocrine Neoplasia of the Pancreas and Biliary Tract 882Andrea Frilling, Ashley K. Clift, and Vito Cicinnati116 Survival after Treatment of Endocrine Tumors 891Zhe Cao and Taiping ZhangSection 8 Neoplastic Tumors of Exocrine Tissue: Pancreatic Cancer 897117 Epidemiology of Pancreatic Cancer 899Evelina Mocci and Alison P. Klein118 Smoking, a Risk for Pancreatic Cancer: Experimental and Clinical Data 905Uwe A. Wittel, Bradley R. Hall, and Surinder K. Batra119 Molecular Understanding of the Development of Ductal Pancreatic Cancer 912Jae W. Lee, Ralph H. Hruban, and Laura D. Wood120 From Tissue Turnover to the Cell of Origin of Pancreatic Cancer: An Updated View 921Bo Kong, Eva Thoma, and Christoph W. Michalski121 Microbiome of Pancreatic Cancer: Involvement in Cancer Development and Chemo- /Immunotherapy 928Xianjun Yu122 Molecular Subtypes and Clinical Applications 934Maarten F. Bijlsma and Peter Bailey123 Tumor Microenvironment: Immune Cells and Immunosuppressive Functions of Carcinoma- associated Fibroblasts and Macrophages 942Tony Pang, Zhihong Xu, Chamini Perera, and Minoti V. Apte124 Familial Pancreatic Cancer 951Alison P. Klein125 Pathology of Exocrine Pancreatic Tumors 957Meredith E. Pittman and Ralph H. Hruban126 Pancreatic Cancer: Precancerous Lesions 969Michael J. Pflüger, Michaël Noë, and Lodewijk A.A. Brosens127 Clinical History and Risk Factors of Pancreatic Cancer 982Norbert Hüser, Volker Aßfalg, and Helmut Friess128 The Role of Endoscopic Ultrasonography in the Diagnosis and Differential Diagnosis of Neoplastic Lesions 989Yoshiki Hirooka, Senju Hashimoto, and Eizaburo Ohno129 Radiologic Diagnosis of Pancreatic Cancer: CT, MRI 997Hannah S. Recht and Elliot K. Fishman130 Screening of Hereditary Pancreatic Cancer 1012Michael Goggins131 The Role of PET in Diagnosis of Pancreatic Cancer and Cancer Recurrence 1021Norbert Hüser, Volker Aßfalg, Isabel Rauscher, and Helmut Friess132 Tumor Markers in Pancreatic Malignancies 1028Shin Hamada and Atsushi Masamune133 The Role of Laparoscopy and Peritoneal Cytology in the Management of Pancreatic Cancer 1033Yosuke Kasai, Kyoichi Takaori, and Etsuro Hatano134 Clinical Assessment and Staging of Advanced Pancreatic Cancer 1037James M. Lindberg, Giles F. Whalen, and Jennifer LaFemina135 Pancreatic Cancer: Indications for Resection 1047Akimasa Nakao and Suguru Yamada136 Pancreatoduodenectomy for Pancreatic Cancer: Short- and Long- term Outcome after Kausch- Whipple and Pylorus- preserving Pancreatoduodenectomy 1055Benedict Kinny- Köster, John L. Cameron, and Jin He137 Left Pancreatectomy for Body and Tail Cancer 1063Jony van Hilst, Mohammad Abu Hilal, and Marc G Besselink138 Total Pancreatectomy: Indications and Limitations 1071Seiko Hirono and Hiroki Yamaue139 Minimally Invasive Resection for Pancreatic Cancer 1078Patricio M. Polanco, Imad Radi, and Herbert J. Zeh iii140 Robotic Resection for Pancreatic Cancer 1093Renyi Qin141 Extended Radical Surgery for Pancreatic Cancer 1099Thilo Hackert, Anna Nießen, and Markus W. Büchler142 Palliative Pancreatic Resection: Is It Justified? 1108Kira C. Steinkraus, Max Heckler, Christoph W. Michalski, and Felix J. Hüttner143 Outcome of Patients after R0 Resection for Locally Advanced Pancreatic Cancer Combined with Hepatic Metastasectomy: Indications and Limitations 1113Tingbo Liang144 Bypass Surgery for Advanced Pancreatic Cancer 1117Eva Thoma, Thilo Hackert, Christoph W. Michalski, and Felix J. Hüttner145 Endoscopic and Interventional Palliation of Pancreatic Cancer 1122Kazumasa Nagai and Takao Itoi146 Neoadjuvant Treatment of Pancreatic Cancer: Evidence for Treatment Effect 1131Robert A. Wolff147 Locally Advanced Pancreatic Cancer: Does the Addition of Stereotactic Body Radiation Therapy to Neoadjuvant Chemotherapy Lead to a Significant Survival Improvement after R0 Resection? 1141Marco Del Chiaro, Michael J. Kirsch, and Richard D. Schulick148 Adjuvant Chemotherapy in Pancreatic Cancer: First Line and Second Line Treatment— Benefits of Survival 1143Kulbir Mann, Robert P. Jones, Paula Ghaneh, and John P. Neoptolemos149 Role of Radiation Therapy for Pancreatic Cancer 1153Baho U. Sidiqi, Abhinav V. Reddy, Joseph M. Herman, and Amol K. Narang150 Immunotherapy for Pancreatic Cancer: Checkpoint Blockade and Vaccine Therapy 1164Arsen Osipov, Adrian G. Murphy, and Lei Zheng151 Targeted Therapies for Pancreatic Cancer 1180Anirban Maitra152 Precision Cancer Medicine 1188Grace Oh, Surajit Dhara, and Diane Simeone153 Palliative Chemotherapy for Advanced Pancreatic Cancer: Treatment Modalities, Side- effects, and Benefits of Survival 1196Christoph Springfeld and Thomas Seufferlein154 Management of Pain in Pancreatic Cancer 1201Annie W. Hsu, Ayodeji Omosule, and Michael Erdek155 Management of Cancer Recurrence 1208Oliver Strobel, Martin Loos, and Markus W. Büchler156 Survival and Late Morbidity after Resection of Pancreatic Cancer 1218Avinoam Nevler and Charles J. YeoSection 9 Periampullary Cancers and Tumors Other Than Pancreatic Cancer 1233157 Periampullary Tumors: Clinical Presentation and Diagnostic Strategies 1235Jon M. Harrison and Keith D. Lillemoe158 Histology and Genetics of Cancer of the Papilla, Distal Common Bile Duct, and Duodenum 1242Yue Xue, Michelle D. Reid, and Volkan Adsay159 Adenoma and Adenocarcinoma of the Ampulla of Vater: Diagnosis and Management 1254Sahin Coban, Omer Basar, and William R. Brugge160 Endoscopic Treatment of Adenomas of the Ampulla of Vater: Techniques, Results, Benefits, and Limitations 1264Natsuyo Yamamoto and Hiroyuki Isayama161 Surgical Treatment of Papillary and Ampullary Tumors: Management and Long- term Results 1272Norbert Hüser, Volker Aßfalg, and Helmut Friess162 Surgical Treatment of Duodenal Cancer 1281Fuyuhiko Motoi163 Surgical Treatment of Distal Cholangiocarcinoma 1284Shunsuke Onoe, Yukihiro Yokoyama, and Tomoki Ebata164 Adjuvant and Palliative Chemotherapy of Periampullary Cancers 1291Arachchige D.N.R. Ponweera, Paula Ghaneh, and John P. Neoptolemos165 Long- term Survival After Resection of Periampullary Cancer 1299Hideyuki Yoshitomi, Masayuki Ohtsuka, and Masaru MiyazakiSection 10 Transplantation of the Pancreas 1309166 Transplantation of Pancreatic Islets 1311Joseph Sushil Rao, Melena D. Bellin, and Bernhard J. Hering167 Transplantation of the Pancreas 1323Rainer W.G. Gruessner and Angelika C. GruessnerIndex 1333