S K MATHUR KISHORE ADYANTHAYA
Pancreatology is fast emerging as a specialty as the number of professionals who seek to understand this gland has increased. A number of national and international societies are now dedicated to the in-depth study of this "hermit organ" once considered to be one of the most dangerous, unpredictable and treacherous organs in the human body.
The name pancreas is derived from Pan meaning all and Kreas meaning flesh or meat. St. Pancreas the patron saint of those suffering from diabetes lies buried in a small chapel under the modern day St. Pancreas railway station. Although, Herophilus in 300 B.C. had given the initial anatomic description of this organ its function remained a mystery. Brunner in the 17th century did not subscribe to the belief that the pancreas played a role in digestion or in the condition of diabetes. For many years, knowledge of the pancreas was limited by the lack of good evaluation methods outside of the operating room or necropsy suit. Surgery was undertaken only with fear and trepidation because of the high incidence of complications.
The last decade has seen an exponential growth in the research of pancreatic disease resulting in new diagnostic methods, imaging techniques, tumour markers and gastrointestinal hormones. This has contributed significantly to our knowledge of the disease and to the development of state of the art therapeutic modalities. Pancreatic disease was once considered uncommon in our country but now because of increased awareness and improved diagnostic techniques a greater number of cases are being diagnosed. The spectrum of the disease seen here is similar to that of western countries. However, there are certain distinctive entities like Tropical Pancreatitis, which acquired the name of Kerala Pancreatitis because of its high incidence in Kerala. Pacreatologists in India have kept pace with international developments in the field. The diagnostic procedures and treatment modalities that are offered here are modern and in keeping with the latest developments in the field.
We are at the thresh hold of understanding more of the gland as research is being carried out in molecular biology gene therapy of pancreatic cancer with the aim of improving patient responsiveness to chemo, radio-immuno and hormonal therapy. Research is on the way to stop and reverse the fibrosis in chronic pancreatitis and to devise more effective tools for pain management. In the acute pancreatitis front new discoveries are being made about the pathways activated during an attack, methods of treating intestinal and pancreatic ischaemia and improving the microcirculation. The future looks exciting for the pancreatologists as new frontiers are being explored in this field of speciality. Any emerging field of science requires an individual with a passion for further exploration, a thirst for greater knowledge and a burning desire for constant improvement to take it from its infancy to its maturity. Prof. VN Shrikhande has played a significant role in improving our knowledge in this growing field of pancreatology. His legendary diagnostic and surgical skill, and vast knowledge have earned him the well deserved reputation of being one of India’s foremost Hepato, pancreato, biliary surgeons. Dr. Shrikhande strives for perfection and inspires others to bring out their best. Despite his penchant for his profession he never forgets his sense of humanity. He is a kind hearted human being first and then a surgeon. This has endeared him to his patients who readily place their life in his hands with implicit trust. He has contributed significantly to give Bombay Hospital its recognition as one of the nations premier institutions and with this reputation preceding it, Bombay Hospital was ideally suited to host the recent international workshop on pancreatology. This workship provided the forum for some of the world’s leading experts in the field to share their knowledge about this very complex organ. Dr. Shrikhande is a devoted teacher whose training has enabled hundreds of residents to practice as skilled surgeons all over the country. It is an honor for us to dedicate this edition on pancreas to Dr. Shrikhande on his 70th birthday.
We thank the contributors who have responded to our request with enthusiasm and promptness. Finally, we thank Dr. OP Kapoor, the editor of the Bombay Hospital Journal, for allowing us to be guest editors for this issue; Dr. RJ Mehta for his help and support and the staff in the Journal Office for all their assistance.
S K MATHUR AND KISHORE ADYANTHAYA