review of literature on clinical pancreatology - The Pancreapedia

Whipple and BraunschweigAllen Oldfather Whipple performed a pylorus-preserving partial pancreatoduoden-ectomy in1935. All pancreatoduodenectomies performed prior to 1937 were nonanatomic resectionsremoving only part <strong>of</strong> the head <strong>of</strong> pancreas and duodenum. On February 11, 1937,Alexander Braunschweig performed a two-stage pylorus-preserving pancreatoduodenectomyfor pancreatic carcinoma at the University <strong>of</strong> Chicago Hospital. This was the first trueanatomic resection with complete removal <strong>of</strong> the pancreatic head to the right <strong>of</strong> the superiormesenteric vein. On March 6, 1950 Allen Whipple operated at New York’s PresbytarianHospital on a patient thought to have carcinoma <strong>of</strong> the antrum <strong>of</strong> stomach. The stomach wasalready divided before it became apparent that the origon <strong>of</strong> the tumor was head <strong>of</strong>pancreas. That operation was most likely the first anatomic one-stage pancreatoduodenectomywith antrectomy and complete removal <strong>of</strong> the duodenum and marks thebeginning <strong>of</strong> modern pancreatic head resection.Rockey and PriestlyA true total pancreatectomy appears to have been first performed by Eugene Rockey <strong>of</strong>Portland, Oregon, on June 22, 1942, but the patient died 15 days later <strong>of</strong> bile peritonits.Three weeks later, on July 15, 1942, James Priestly <strong>of</strong> Rochester, Minnesota, performed atotal pancreatectomy on a 40 year old women who suffered from hypoglycemic episodes. Hecould not find the pancreatic tumor on exploration and therefore made the radical decision toperform a total pancreatectomy for what turned out to be a 1 cm insulinoma. The patientsurvived for 29 years before dying <strong>of</strong> cholangitis.Pancreatic duct drainage in chronic pancreatitis and pancreatic cancerWith the evolution <strong>of</strong> understanding <strong>of</strong> pathophysiology <strong>of</strong> chronic pancreatitis, Goethe Link<strong>of</strong> Indianaplois, Indiana, performed in March 1910 an exploration <strong>of</strong> the pancreatic duct,extracted a pancreatic duct stone and created an external distal tube pancreatostomy with agood long-term outcome. Short segment, loop pancreatojejunostomies stented by a T-tubewas performed by Richard Cattell for patients with pain from an unresectable pancreaticcancer in the 1940s.In 1951, William Longmire performed a caudal pancreatectomy with end-to-endpancreatojejunostomy later popularized by Merlin DuVal in 1954. In 1958, Charles Puestowand William Gillesby <strong>of</strong> Chicago, Illinois, modified this procedure to a caudal pancreatectomywith splenectomy, and extended longitudinal opening <strong>of</strong> the pancreatic duct and Roux-en-Yend-to-side or side-to-side pancreatojejunostomy. In 1960, Phillip Partington and RobertRochelle <strong>of</strong> Cleveland, Ohio, simplified the procedure by eliminating the caudalpancreatectomy and splenectomy. These pancreatic duct drainage procedure procedurespaved the way to the lateral pancreatojejunostomy with limited nonanatomic pancreatic headresection described by Charles Frey in 1987 and the duodenum-preserving partivalpancreatic head resection described by Hans Beger in 1980.Pancreatic transplantationEver since the first transplant in 1967 by Kelly and Lillihei, University <strong>of</strong> Minnesota has beenin forefront. The first pancreas islets autotransplant in the late seventies, successfulpancreas transplant series, livning donor pancreas transplant, living simultaneous kidneypancreas transplants open as well as laparoscopic are some <strong>of</strong> the more recentaccomplishments reported from this center.