Past, present, and future of pancreatic surgery

The advances in the surgical treatment of pancreatic disease in the 20th century were built on careful anatomic and physiologic studies dating to the early 1800s. Operations for neoplastic diseases developed in the 1930s by Whipple, Trimble, and others allowed pancreatic malignancies to be removed with ever increasing safety. Endocrine tumors of the pancreas were described and treated surgically. Patients with pancreatitis now have a number of surgical alternatives available for their individual circumstances. The future of surgery for pancreatic disease lies in the results of the human genome project and the fields of genomics and proteomics that resulted. The rapidity with which knowledge of gene expression is advancing owing to new technologies such as the microarray biochip is amazing. The future of pancreatic surgery is bright.