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1、CHAPTER40ENDOCRINEPANCREASTaylorS.RiallandCourtneyM.Townsend,Jr.secreteinsulin,delta(D)cellssecretesomatostatinandvasoac-histomorphologyofisletstiveintestinalpeptide(VIP),andFcellssecretepancreaticpoly-embryologyoftheendocrinepancreaspeptide(PP).Gastrin-producin
2、gcellsarenormallypresentinendocrinephysiologythefetalpancreasonly.Isletcelltumorsmaysecreteoneormoresurgicaltreatmentofdiabetesofthesehormones.Theresultingsyndromesarenamedfortheisletcelltumorspeptidewhoseclinicalsymptomspredominate.summaryInthischapter,wewillco
3、verthehistomorphology,embry-ology,andphysiologyoftheendocrinepancreas.Wewillbrieflyhighlightnewtechnologies,includingautologousisletcelltrans-plantationforchronicpancreatitisandallogeneicisletcelltrans-Thepancreasisadigestiveorganlocatedintheretroperitoneumplant
4、ationfortype1diabetes.Ourfocuswillbeonthediagnosis(Fig.40-1)thathasendocrineandexocrinefunction.Theendo-andmanagementofendocrinetumorsofthepancreas.crinecellsareorganizedindiscreteclumpsthroughoutthepancreas,calledisletsofLangerhans.TheprimaryphysiologicHISTOMOR
5、PHOLOGYOFISLETSfunctionoftheendocrinepancreascanbesummarizedasregula-Inthehumanfetus,pancreaticisletscompriseapproximatelytionofbodyenergy,largelythroughhormonalcontrolofcarbo-onethirdofthepancreaticmass.Intheadultpancreas,there6hydratemetabolism.Theisletssecret
6、ehormonesdirectlyintoareapproximately10isletsintheadultpancreas,accountingthebloodstreaminendocrinefashion.Insulinisthehormoneforlessthan2%oftheoverallpancreaticmass.Theaverageofenergystorage,whileglucagonisthehormoneofenergyisletcontainsapproximately3000cellsan
7、drangesindiameterrelease.Additionalpancreaticendocrinehormones,suchasfrom40to900µm.Eachpancreaticisletshouldbeconsideredsomatostatin,playaroleinthecomplexregulationofpancreaticamicroorganismwithacomplexanddefiniteorganization,exocrinesecretionanddigestion.withon
8、lyintactisletarchitectureenablingnormalendocrineThepancreaswasfirstidentifiedbyaGreekanatomistandfunction.surgeon,Herophilus(335-280BC).InmedievalPersia,in1025,Theisl
