Clem Imrie and Colin Johnson This book stems from an unusual meeting held in The Royal College of Physicians and Surgeons of Glasgow in March 2007. Enthusiastic doctors in the diagnosis and treatment of pancreatic diseases were arranged in small groups to discuss specific unsolved/partially clinical problems and suggest the way forward. In some instances, the recommendations were initial improved longitudinal studies, while in others better double-blind randomized st- ies. The recommendations were then presented on the second day before the total 40 plus participants who added their input. Finally, the mechanics of initiating the proposals were arranged. The editors are most thankful to the authors from the meeting, who have ass- bled the various contributions to this stimulating volume. xi Part I Potential Trials in Acute Pancreatitis Chapter 1 Acute Pancreatitis in Intensive Care John Kinsella, Barry Clements, Euan Dickson, Thierry Dugernier, and Martin Hughes 1.1 Intr oduction Severe acute pancreatitis is associated with the development of the systemic inflammatory response syndrome (SIRS). Hypoxemia is a hallmark of acute pancreatitis and respiratory failure is the most common single organ failure in this disease. In the most severely ill patients mul- organ dysfunction syndrome (MODS) and multi-organ failure (MOF) occur. Intensive care with multiple organ support is necessary.

Potential Trials in Acute Pancreatitis.- Acute Pancreatitis in Intensive Care.- Antibiotic Prophylaxis in Acute Severe Pancreatitis: Should We Have a Further Study?.- Designing an Optimal Study for the Management of Infected Pancreatic Necrosis.- Nutrition in Acute Pancreatitis.- An Optimal Randomized Study for Pain Control in Acute Pancreatitis.- Potential Trials in Chronic Pancreatitis.- Endoscopic Versus Surgical Drainage for Chronic Pancreatitis.- Duodenum-Preserving Pancreatic Resection with Pancreatic Duct Drainage: What Is the Role of Supraduodenal Biliary Drainage?.- Potential Trials in Pancreatic Cancer.- Pain Management and Nutritional Support in Nonresectable Pancreatic Cancer.- Endoscopic Therapy in the Palliation of Nonresectable Pancreatic Cancer.- Pancreatic Endocrine Tumors.- The Role of the Systemic Inflammatory Response in Predicting Outcome in Patients with Pancreatic Cancer.- Topic Reviews.- Botulinum Toxin and the Sphincter of Oddi.- The European Study Group for Pancreatic Cancer (ESPAC) Trials.

Clem Imrie and Colin Johnson This book stems from an unusual meeting held in The Royal College of Physicians and Surgeons of Glasgow in March 2007. Enthusiastic doctors in the diagnosis and treatment of pancreatic diseases were arranged in small groups to discuss specific unsolved/partially clinical problems and suggest the way forward. In some instances, the recommendations were initial improved longitudinal studies, while in others better double-blind randomized st- ies. The recommendations were then presented on the second day before the total 40 plus participants who added their input. Finally, the mechanics of initiating the proposals were arranged. The editors are most thankful to the authors from the meeting, who have ass- bled the various contributions to this stimulating volume. xi Part I Potential Trials in Acute Pancreatitis Chapter 1 Acute Pancreatitis in Intensive Care John Kinsella, Barry Clements, Euan Dickson, Thierry Dugernier, and Martin Hughes 1.1 Intr oduction Severe acute pancreatitis is associated with the development of the systemic inflammatory response syndrome (SIRS). Hypoxemia is a hallmark of acute pancreatitis and respiratory failure is the most common single organ failure in this disease. In the most severely ill patients mul- organ dysfunction syndrome (MODS) and multi-organ failure (MOF) occur. Intensive care with multiple organ support is necessary.