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Pancreatitis
  1. A N KINGSNORTH

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    Pancreatitis. Lankisch PG, Banks PA. (Pp 377; illustrated; £57.00.) Berlin: Springer-Verlag, 1998. ISBN 3-540-61726-4.

    This book will be a bench mark by which others on the subject of pancreatitis will be judged. This is no ordinary volume assembled by two hard-pressed editors from an array of international experts with differing styles and experience but a text written solely by two eminent authors. The gestation period was 10 years, the evidence base is 1900 citations and the bias is distinctly clinical—that is, this is a reference book for the working gastroenterologist (surgeon or physician), not a text littered with incomprehensible molecular biology.

    The two diseases, acute and chronic pancreatitis, are dealt with in a similar format, beginning with classification, aetiology, pathology, and epidemiology, progressing to the clinicians’ holy grail: diagnosis and treatment. Herein lies the book’s strength. There is no artificial segregation into separate sections by a radiologist, an endoscopist or a surgeon, but an integrated and detailed overview giving practical guidance. For two disease processes whose pathogenesis is poorly understood and for which there are few specific therapies, it is obviously necessary for guidance to be more than anecdotal. Thus, where there is controversy the literature has been carefully sifted through, debated and a bottom line recommendation reached. The approach is not nihilistic, but thoroughly positive in its analysis of international efforts to solve the conundrum of pancreatitis.

    So what gems can be extracted to whet your appetite? Firstly a riveting discussion of scoring systems and prognostic signs in acute pancreatitis, a topic which often switches off the relative newcomer to this area but which holds the key to stratification for current or new treatment options. Ranson, Imrie and APACHE II take on a new life, liberally illustrated with explanatory figures and tables. Secondly, there is a clear and detailed discussion of the merits and practical value of the various pancreatic function tests which can be used in chronic pancreatitis. When to use each one, sensitivity and specificity, and practical tips bring clarity to an often muddled area. And on the back of this come recommendations for intervention and treatment. In my opinion the chapters on treatment cannot be bettered. Finally, although the authors are both physicians the surgical options available are debated sensibly and concisely and placed in a realistic perspective.

    Any doctor treating patients with pancreatitis can be recommended to buy and enjoy this exceptional book.

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