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Acute pancreatitis:Etiology and common pathogenesis

World Journal of Gastroenterology 2009年第12期15卷 1427-1430页

作者： Guo-Jun Wang Chun-Fang Gao Dong Wei Cun Wang Si-Qin Ding Institute of Digestive Surgery and Department of General Surgery 150 Hospital of Chinese PLA Gaoxin District Luoyang 471031 Henan Province China

Acute pancreatitis is an inflammatory disease of the *** etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries *** causes of acute pancreatitis have been discovered,but the pathogenetic theories are *** most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic *** majority ofinvestigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin *** pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are ***,little is known about the other acute *** hypothesize that acute biliary pancreatitis and other causes of acute pancreatitis possess a common *** hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure,active trypsin reflux,and subsequent unregulated activation of trypsin within pancreatic acinar *** activation within the pancreas leads to auto-digestion of the gland and local *** the hypothesis is confirmed,traditional therapeutic strategies against acute pancreatitis may be *** of pancreatic duct pressure should be advocated in the treatment of acute pancreatitits which may greatly improve its outcome.

关键词： Acute pancreatitis Pathogenesis Etiology pancreatic duct obstruction pancreatichyperstimulation pancreatic duct pressure

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Integrity of the pancreatic duct-acinar system in the pathogenesis of acute pancreatitis

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Hepatobiliary & pancreatic Diseases International 2010年第3期9卷 242-247页

作者： Wang, Guo-Jun Li, Yuan Zhou, Zong-Guang Wang, Cun Meng, Wen-Jian Sichuan Univ W China Hosp Inst Digest Surg Chengdu 610041 Peoples R China Sichuan Univ W China Hosp Dept Gen Surg Chengdu 610041 Peoples R China

BACKGROUND: Acute pancreatitis is an acute inflammatory process of the pancreas that frequently involves peripancreatic tissues and at times remote organ systems. For a long time, the etiology and pathogenesis of acute pancreatitis has been intensively investigated worldwide, but the pathogenetic theories are controversial. The integrity of the pancreatic duct-acinar system might play an important role in the pathogenesis of this disease. DATA SOURCES: Web of Science and PubMed databases were searched for published studies (between January 1966 and June 2009) to identify relevant articles using the keywords 'acinar hyperstimulation', 'pathogenesis', 'acute pancreatitis', 'pancreatic duct-acinar system', and 'pancreatic duct pressure'. Most of the relevant articles were reviewed. RESULTS: From critical reading of the relevant articles, we found that the underlying mechanisms involved in the pathogenesis of acute pancreatitis are still under debate and ill-understood. On the basis of the relevant studies, we propose a hypothesis for the pathogenesis of acute pancreatitis, in which the integrity of the pancreatic duct-acinar system plays an essential role in the onset and progression of various forms of the disease. CONCLUSIONS: In our hypothesis, pancreatic duct obstruction and hyperstimulation of the exocrine pancreas are preconditions for the onset of acute pancreatitis; under the common conditions of pancreatic duct obstruction and acinar hyperstimulation, acute pancreatitis arises and develops. This may be an important common pathophysiological mechanism causing various forms of acute pancreatitis. (Hepntobiliary Pancreat Dis Int 2010; 9: 242-247)

关键词： pancreatic duct-acinar system pathogenesis acute pancreatitis acinar hyperstimulation pancreatic duct pressure

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