胰腺疾病英文课件.pptx

Department of SurgeryRuijin Clinical Medical CollegeShanghai Jiao Tong UniversityPancreatic Disease第1页 Anatomy of pancreasPancreatitis Pancreatic pseudocystPancreatic cancer第2页 Anatomy Location: retroperitoneal 第3页 head neck body tailuncinate process SMVpancreatic duct wirsung ductaccessory pancreatic duct santorini duct第4页 Arterieshead & neckceliac axis, superior mesenteric artery GDAsuperior & inferior pancreaticoduodenal Asuperior & inferior pancreatic arteriesbody & tailsplenic & left gastroepiploic arteries第5页 Veins Superior mesenteric vein Splenic vein Portal vein第6页 Lymph & Nervelymph SPD SP splenic hilum IPD IP head SMA nodes celiac axis nodes tail splenic nodesnerve sympathetic & parasympathetic第7页 Histoloy & physiologyExocrine acinar cell digestive enzymes ductal cell bicarbonate secretion of control vagal & CCK第8页 Histoloy & physiologyEndocrine islets of Langerhans βcell 50% insulin αcell 20% glucagon δ cell 5% somatostatin nonβcell vasoactive intestinal peptide nonβcell gastrin nonβcell pancreatic polypeptide（PP）第9页 Acute Pancreatitis第10页 DefinitionAcute pancreatitis (AP) is an acute inflammatory process of the pancreas, with variable involvement of other regional tissue or remote organ systems.The disease includes a broad spectrum of pancreatic disease, which varies from mild parenchymal edema to severe hemorrhagic pancreatitis associated with subsequent gangrene and necrosis.. 第11页 The clinical presentationPain of abdomen is diffuseHypotension Metabolic derangementsSepsis Fluid sequenstrationMultiple organ failure Death 第12页 EtiologyGallstones Sustained alcoholOther In china : biliary tract disease distal common bile duct stone stenosis of the papilla of Vater ascarid in biliary duct第13页 PathogenesisA complicated pathophysiologic processEnzyme autoactivation and self-digestion True mechanism remains unknown第14页 Pancreatic self-protective mechan