Regional Hepato-Pancreatico-Biliary Unit - Surrey and Sussex

Associated sites:   Liver-cancer.co.uk,    Liver.org.uk,   Gallstones.co.uk

Historical Facts about the Pancreas

The pancreas was first described in 300 B.C by Herophilus of Chalcedon. In 100 A.D Aretaus described the term diabetes.  It was Rufus of Ephesus who coined the term "pan-kreas" meaning 'all flesh'.  In 1541 Andreas Vesalius first illustrated the pancreas and in 1642 Johann Wirsung discovered the pancreatic duct.  In 1654 Francis Glisson of Cambridge described the sphincter mechanism at the end of the common bile duct. In 1674 Thomas Willis of Oxford described diabetes mellitus. In 1869 Paul Langerhans discovered the Islets of the pancreas where Insulin was made and in 1872 Alexander Danilewski discovered trypsin, the protein digesting enzyme, made in the pancreas.  In 1922 Banting and Best discovered Insulin a hormone that controls blood sugar levels. 

Pancreatic Surgery

Pancreatic surgery really started in 1879 when Thiersch first drained a fluctuating tumour in the abdomen which was a pancreatic cyst.  The resulting pancreatic fistula eventually dried up spontaneously.  However, the first serious pancreatic surgery began in the 1900s and in 1909 Coffey performed the first pancreatic anastomosis (join) to the bowel. In 1923 Jedlicka successfully anastomosed a pancreatic cyst to the back of the stomach and in 1946 Konig drained a pancreatic cyst  into a Roux-en-Y loop of jejunum.  In 1882 Trendelenburg carried out the first distal pancreatectomy (left sided pancreatic resection).  The first successful removal of a peri-ampullary cancer was carried out by William Halsted in 1898 and this involved local excision. 

The first true pancreatico-duodenectomy was carried out by Kausch in 1909 operating on a 49 year old man.  This was a two stage procedure.  Subsequently in 1935 A.O.Whipple performed a two stage pancreatico-duodenectomy. By 1940 he had perfected the single stage operation and by 1941 over 40 cases had been reported with an operative mortality of 27 %. To date there are many variations in the type of reconstruction of the Kausch-Whipple procedure.  The procedure of pylorus-preserving pancreatico-duodenectomy was popularised by Traverso and Longmire in 1978.