Book Review

Diseases of the Pancreas: Current Surgical Therapy

N Engl J Med 2008; 359:770-771August 14, 2008

Article

Diseases of the Pancreas: Current Surgical Therapy
Edited by Hans G. Beger, Seiki Matsuno, and John L. Cameron. 949 pp., illustrated. Berlin, Springer, 2008. $339. ISBN: 978-3-540-28655-4

The pancreas is one of the least accessible abdominal organs, and even in the 21st century it carries an aura of mystery and challenge. Benign diseases of the pancreas are often complex and can prove to be a diagnostic and therapeutic challenge, and despite advances, cancer of the pancreas still carries a dismal prognosis. This comprehensive yet concise book focuses on the surgical treatment of diseases of the pancreas and was edited by three leaders in the field from three continents. The book, therefore, has a stamp of authority.

The contents of Diseases of the Pancreas have been planned carefully, and the systematic organization of the chapters makes the book readable and provides an in-depth yet readily understandable review of the surgical aspects of pancreatic disease. The anatomical, physiological, and pathological bases of pancreatic disease are dealt with in detail, and the sections on genetics, molecular and cellular biology, and imaging are well written. The disease-specific chapters are largely evidence-based, and the arguments for choice of treatment are balanced. Rarer diseases of the pancreas, trauma, and transplantation are also discussed adequately. The 680 figures that accompany the text are of a high quality and were chosen well. Clear diagnostic and therapeutic algorithms are also included.

Color-Enhanced Scanning Electron Micrograph of a Pancreatic Cancer Cell.

Although this book is not an atlas of operative surgery, I particularly liked the sections describing operations on the pancreas. These chapters are comprehensive and include discussions of preoperative preparation and postoperative care. There are very clear indications and contraindications listed for each operation, and the descriptions of the techniques reflect the wealth of the authors' personal experience. The diagrams depicting the operative procedures are of exceptional quality and complement the text perfectly. There are also substantial, well-written sections on laparoscopic surgery of the pancreas. The book does not stop at surgical treatment but also includes sections on adjuvant and neoadjuvant therapy, palliative care, and newer experimental treatment for pancreatic cancer.

The book has a few shortcomings, but these do not detract from its overall quality. There are some typographical errors, and the most recent references in some chapters date to 2000. However, in most of the chapters the bibliography does extend to articles published in 2007. As endoscopic ultrasonography is now playing an important role in the diagnostic algorithm for pancreatic disease, I would like to have seen a chapter on the topic in the section titled “Clinical Standards of Diagnostic Measures.” Antiretroviral drugs could have been included in the list of drugs that cause acute pancreatitis, and the diagnosis and treatment of autoimmune pancreatitis could have been discussed in more detail.

In the preface, the editors state their hope that this book “will become an important reference material for the newest data regarding pancreatic diseases and the surgical management of common and rare pancreatic lesions.” They have succeeded in their task, and this book will occupy an important place on my bookshelf. (It will be also taken off the bookshelf and used frequently.) I am sure that it will be of major interest not only to specialists in pancreatic disease but also to generalists, trainees, and ancillary staff who care for patients with diseases of the pancreas.

Dileep N. Lobo, D.M., F.R.C.S.
Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom
dileep.lobo@nottingham.ac.uk