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Из истории панкреатологии и классификации панкреатитов
Из истории панкреатологии и классификации панкреатитов
Дубцова Е.А., Винокурова Л.В. Из истории панкреатологии и классификации панкреатитов. Терапевтический архив. 2026;98(2):131–136. DOI: 10.26442/00403660.2026.02.203527
© ООО «КОНСИЛИУМ МЕДИКУМ», 2026 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2026 г.
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Аннотация
Ретрогастральное расположение, небольшие размеры и мягкая консистенция поджелудочной железы стали причиной позднего открытия физиологии этого органа. Первые сведения об анатомии и физиологии поджелудочной железы появились только в XVI–XVII вв. Роль поджелудочной железы в пищеварении изучена в XVIII–XIX вв., участие ее в углеводном обмене – в XIX в., а инсулин открыт в первой половине XX в. Клинические признаки панкреатита впервые описаны в начале XIX в., однако диагностика этого заболевания до сих пор представляет определенные трудности. То же можно сказать и о классификации панкреатитов. В силу многообразия этиологических факторов и клинических проявлений острого и особенно – хронического панкреатита единая универсальная классификация панкреатита пока не создана, несмотря на неоднократные попытки и существующие классификации.
Ключевые слова: поджелудочная железа, панкреатология, панкреатиты, история, классификация
Keywords: pancreas, pancreatology, pancreatitis, history, classification
Ключевые слова: поджелудочная железа, панкреатология, панкреатиты, история, классификация
________________________________________________
Keywords: pancreas, pancreatology, pancreatitis, history, classification
Полный текст
Список литературы
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14. Etemad B, Whitcomb D C. Chronic pancreatitis: Diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120(3):682-707. DOI:10.1053/gast.2001.22586
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24. Rahman A, O’Connor DB, Gather F, et al. Clinical Classification and Severity Scoring Systems in Chronic Pancreatitis: A Systematic Review. Dig Surg. 2020;37:181-91. DOI:10.1159/000501429
25. Sarner M, Cotton PB. Classification of pancreatitis. Gut. 1984;25(7):756-9. DOI:10.1136/gut.25.7.756
26. Axon AT, Classen M, Cotton PB, et al. Pancreatography in chronic pancreatitis: interational Definitions. Gut. 1984;25:1107-12. DOI:10.1136/gut.25.10.1107
27. Бахтин В.А., Янченко В.А., Прокопьев В.С.. К вопросу о классификации хронического панкреатита. Вятский медицинский вестник. 2009;2-4:4-8 [Bakhtin VA, Yanchenko VA, Prokopyev VS. On the classification of chronic pancreatitis. Vyatka Medical Bulletin. 2009;2-4:4-8 (in Russian)].
28. Буриев И.М., Цвиркун В.В., Глабай В.П., Кочатков А.В. Классификация хронического панкреатита. Анналы хирургической гепатологии. 2005;10(3):67-79 [Buriev IM, Tsvirkun VV, Glabay VP, Kochatkov AV. Classification of chronic pancreatitis. Annals of Surgical Hepatology. 2005;10(3):67-79 (in Russian)].
29. Sarles H. Definition and classification pancreatitis. Pancreas. 1991;6:470-4. DOI:10.1097/00006676-199107000-00015
30. Лысенко И.М. Болезни поджелудочной железы. Охрана материнства и детства. 2012;1(19):64-70 [Lysenko IM. Diseases of the pancreas. Maternal and Child Health. 2012;1(19):64-70 (in Russian)].
31. Ивашкин В.Т., Хазанов А.И., Пискунов Г.Г., и др. О классификации хронического панкреатита. Клиническая медицина. 1990;68(10):96-9 [Ivashkin VT, Khazanov AI, Piskunov GG, et al. On the classification of chronic pancreatitis. Clinical Medicine. 1990;68(10):96-9 (in Russian)].
32. Rossell MC. History of the pancreas and the evolution of concepts and classification of pancreatitis. Rev Gastroenterol Peru. 2002;22(3):243-7.
33. Шалимов А.А., Копчак В.М., Тодуров И.М., Дронов А.И. Диагностика и хирургическое лечение хронического панкреатита. Анналы хирургической гепатологии. 1998;3(3):7-9 [Shalimov AA, Kopchak VM, Todurov IM, Dronov AI. The diagnosis and surgical treatment of chronic pancreatitis. Annals of Surgical Hepatology. 1998;3(3):7-9 (in Russian)].
34. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11. DOI:10.1136/gutjnl-2012-302779
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36. Ramesh H. Proposal for a new grading system for chronic pancreatitis: the ABC system. J Clin Gastroenterol. 2002;35(1):67-70. DOI:10.1097/00004836-200207000-00014
37. Schneider A, Lohr JM, Singer MV. The M-ANNHEIN – classification of chronic pancreatitis: Introduction of a unifying classification system based on revien of previous classification of the disease. J Gastroenterol. 2007;42(2):101-19. DOI:10.1007/s00535-006-1945-4
38. Bagul A, Siriwardena AK. Evaluation of the Manchester classification system for chronic pancreatitis. JOP. 2006;7(4):390-6.
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40. Catalano MF, Sahai A, Levy M, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: The Rosemont classification. Gastrointest Endosc. 2009;69(7):1251-61. DOI:10.1016/j.gie.2008.07.043
41. Whitcomb DC; North American Pancreatitis Study Group. Pancreatitis: TIGAR-O Version 2 Risk/Etiology Checklist With Topic Reviews, Updates, and Use Primers. Clin Transl Gastroenterol. 2019;10(6):e00027. DOI:10.14309/ ctg.0000000000000027
2. Modlin IM, Kidd M. The Paradox of the Pancreas: from Wirsung to Whipple. Hannover: Politzki Print Productions, 2004.
3. Ceranowicz P, Cieszkowski J, Warzecha Z, et al. The Beginnings of Pancreatology as a Field of Experimental and Clinical Medicine. Biomed Res Int. 2015;2015:128095. DOI:10.1155/2015/128095
4. Ternovsky VN. Andrei Vesalii. Moscow: Nauka, 1965 (in Russian).
5. Flati G, Andrén-Sandberg A. Wirsung and Santorini: the men behind the ducts. Pancreatology. 2002;2(1):4-11. DOI:10.1159/000049441
6. Sachs M. Study of the pancreas and its inflammatory diseases from the 16th-19th century. Zentralbl Chir. 1993;118(11):702-11.
7. Sakula A. Paul Langerhans (1847–1888): a centenary tribute. J Royal Soc Med. 1988;81(7):414-5. DOI:10.1177/014107688808100718
8. Gubergryts NB, Belyaeva NV. Exo and endocrine function of the pancreas: one step from a duet to a duel. Modern Gastroenterology. 2006;4(30):18-30 (in Russian).
9. Navarro S. Chronic pancreatitis. Some important historical aspects. Gastroenterol Hepatol. 2018;41(7):474.e1-e8. DOI:10.1016/j.gastrohep.2018.04.008
10. Busnardo AC, DiDio J, Tidrick RT, Thomford NR. History of the pancreas. Am J Surg. 1983;146(5):539-50. DOI:10.1016/0002-9610(83)90286-6
11. O'Reilly DA, Kingsnorth AN. A brief history of pancreatitis. J R Soc Med. 2001;94(3):130-2. DOI:10.1177/014107680109400308
12. Pohle T, Konturek JW, Domschke W, Lerch MM. Spontaneous flow of bile through the human pancreatic duct in the absence of pancreatitis: nature's human experiment. Endoscopy. 2003;35(12):1072-5. DOI:10.1055/s-2003-44586
13. Yoshida K, Toni F, Takeuchi T, et al. Chronic pancreatitis caused by an autoimmune abnormality proposal of the concept of autoimmune pancreatitis. Dig Dis Sci. 1995;40:1561-8. DOI:10.1007/BF02285209
14. Etemad B, Whitcomb D C. Chronic pancreatitis: Diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120(3):682-707. DOI:10.1053/gast.2001.22586
15. Plagemann S, Welte M, Izbicki JR, Bachmann K. Surgical Treatment for Chronic Pancreatitis: Past, Present, and Future. Gastroenterol Res Pract. 2017;2017:8418372. DOI:10.1155/2017/8418372
16. Griffin JF, Poruk KE, Wolfgang CL. Pancreatic cancer surgery: past, present, and future. Chinese J Cancer Res. 2015;27(4):332-48. DOI:10.3978/j.issn.1000-9604.2015.06.07
17. Kovanov VV. Operativnaia khirurgiia i topographicheskaia anatomiia. 4e izd, dop. Moscow: Meditsina, 2001 (in Russian).
18. Crist DW, Cameron JL The current status of the Whipple operation for periampullary carcinoma. Adv Surg. 1992;25:21-49.
19. Slezak LA, Andersen DK. Pancreatic resection: effects on glucose metabolism. World J Surg. 2001;25(4):452-60. DOI:10.1007/s002680020337
20. Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas. 1987;2(6):701-7. DOI:10.1097/00006676-198711000-00014
21. Dominguez-Munoz JE, Drewes AM, Lindkvist B, et al. Recommendations from the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis. Pancreatology. 2018;18(8):847-54. DOI:10.1016/j.pan.2018.09.016
22. Gupte A, Goede D, Tuite R, Forsmark CE. Chronic pancreatitis. BMJ. 2018;361:k2126. DOI:10.1136/bmj.k2126
23. Büchler MW, Martignoni ME, Friess H, Malfertheiner P. A proposal for a new clinical classification of chronic pancreatitis. BMC Gastroenterol. 2009;9(1):93. DOI:10.1186/1471-230X-9-93
24. Rahman A, O’Connor DB, Gather F, et al. Clinical Classification and Severity Scoring Systems in Chronic Pancreatitis: A Systematic Review. Dig Surg. 2020;37:181-91. DOI:10.1159/000501429
25. Sarner M, Cotton PB. Classification of pancreatitis. Gut. 1984;25(7):756-9. DOI:10.1136/gut.25.7.756
26. Axon AT, Classen M, Cotton PB, et al. Pancreatography in chronic pancreatitis: interational Definitions. Gut. 1984;25:1107-12. DOI:10.1136/gut.25.10.1107
27. Bakhtin VA, Yanchenko VA, Prokopyev VS. On the classification of chronic pancreatitis. Vyatka Medical Bulletin. 2009;2-4:4-8 (in Russian).
28. Buriev IM, Tsvirkun VV, Glabay VP, Kochatkov AV. Classification of chronic pancreatitis. Annals of Surgical Hepatology. 2005;10(3):67-79 (in Russian).
29. Sarles H. Definition and classification pancreatitis. Pancreas. 1991;6:470-4. DOI:10.1097/00006676-199107000-00015
30. Lysenko IM. Diseases of the pancreas. Maternal and Child Health. 2012;1(19):64-70 (in Russian).
31. Ivashkin VT, Khazanov AI, Piskunov GG, et al. On the classification of chronic pancreatitis. Clinical Medicine. 1990;68(10):96-9 (in Russian).
32. Rossell MC. History of the pancreas and the evolution of concepts and classification of pancreatitis. Rev Gastroenterol Peru. 2002;22(3):243-7.
33. Shalimov AA, Kopchak VM, Todurov IM, Dronov AI. The diagnosis and surgical treatment of chronic pancreatitis. Annals of Surgical Hepatology. 1998;3(3):7-9 (in Russian).
34. Banks PA, Bollen TL, Dervenis C, et al. Classification of acute pancreatitis-2012: revision of the Atlanta classification and definitions by international consensus. Gut. 2013;62(1):102-11. DOI:10.1136/gutjnl-2012-302779
35. Gubergrits NB, Khristich TN. Klinicheskaia pankreatologiia. Donetsk: Lebed, 2000 (in Russian).
36. Ramesh H. Proposal for a new grading system for chronic pancreatitis: the ABC system. J Clin Gastroenterol. 2002;35(1):67-70. DOI:10.1097/00004836-200207000-00014
37. Schneider A, Lohr JM, Singer MV. The M-ANNHEIN – classification of chronic pancreatitis: Introduction of a unifying classification system based on revien of previous classification of the disease. J Gastroenterol. 2007;42(2):101-19. DOI:10.1007/s00535-006-1945-4
38. Bagul A, Siriwardena AK. Evaluation of the Manchester classification system for chronic pancreatitis. JOP. 2006;7(4):390-6.
39. Sablin OA, Ilchishina TA. Chronic pancreatitis: classification and possibilities of enzyme therapy. Gastroenterology of St. Petersburg. 2010;1:23-6 (in Russian).
40. Catalano MF, Sahai A, Levy M, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: The Rosemont classification. Gastrointest Endosc. 2009;69(7):1251-61. DOI:10.1016/j.gie.2008.07.043
41. Whitcomb DC; North American Pancreatitis Study Group. Pancreatitis: TIGAR-O Version 2 Risk/Etiology Checklist With Topic Reviews, Updates, and Use Primers. Clin Transl Gastroenterol. 2019;10(6):e00027. DOI:10.14309/ ctg.0000000000000027
2. Modlin IM, Kidd M. The Paradox of the Pancreas: from Wirsung to Whipple. Hannover: Politzki Print Productions, 2004.
3. Ceranowicz P, Cieszkowski J, Warzecha Z, et al. The Beginnings of Pancreatology as a Field of Experimental and Clinical Medicine. Biomed Res Int. 2015;2015:128095. DOI:10.1155/2015/128095
4. Терновский В.Н. Андрей Везалий М.: Наука, 1965 [Ternovsky VN. Andrei Vesalii. Moscow: Nauka, 1965 (in Russian)].
5. Flati G, Andrén-Sandberg A. Wirsung and Santorini: the men behind the ducts. Pancreatology. 2002;2(1):4-11. DOI:10.1159/000049441
6. Sachs M. Study of the pancreas and its inflammatory diseases from the 16th-19th century. Zentralbl Chir. 1993;118(11):702-11.
7. Sakula A. Paul Langerhans (1847–1888): a centenary tribute. J Royal Soc Med. 1988;81(7):414-5. DOI:10.1177/014107688808100718
8. Губергриц Н.Б., Беляева Н.В. Экзо и эндокринная функция поджелудочной железы: один шаг от дуэта до дуэли. Сучасна гастроентерологія. 2006;4(30):18-30 [Gubergryts NB, Belyaeva NV. Exo and endocrine function of the pancreas: one step from a duet to a duel. Modern Gastroenterology. 2006;4(30):18-30 (in Russian)].
9. Navarro S. Chronic pancreatitis. Some important historical aspects. Gastroenterol Hepatol. 2018;41(7):474.e1-e8. DOI:10.1016/j.gastrohep.2018.04.008
10. Busnardo AC, DiDio J, Tidrick RT, Thomford NR. History of the pancreas. Am J Surg. 1983;146(5):539-50. DOI:10.1016/0002-9610(83)90286-6
11. O'Reilly DA, Kingsnorth AN. A brief history of pancreatitis. J R Soc Med. 2001;94(3):130-2. DOI:10.1177/014107680109400308
12. Pohle T, Konturek JW, Domschke W, Lerch MM. Spontaneous flow of bile through the human pancreatic duct in the absence of pancreatitis: nature's human experiment. Endoscopy. 2003;35(12):1072-5. DOI:10.1055/s-2003-44586
13. Yoshida K, Toni F, Takeuchi T, et al. Chronic pancreatitis caused by an autoimmune abnormality proposal of the concept of autoimmune pancreatitis. Dig Dis Sci. 1995;40:1561-8. DOI:10.1007/BF02285209
14. Etemad B, Whitcomb D C. Chronic pancreatitis: Diagnosis, classification, and new genetic developments. Gastroenterology. 2001;120(3):682-707. DOI:10.1053/gast.2001.22586
15. Plagemann S, Welte M, Izbicki JR, Bachmann K. Surgical Treatment for Chronic Pancreatitis: Past, Present, and Future. Gastroenterol Res Pract. 2017;2017:8418372. DOI:10.1155/2017/8418372
16. Griffin JF, Poruk KE, Wolfgang CL. Pancreatic cancer surgery: past, present, and future. Chinese J Cancer Res. 2015;27(4):332-48. DOI:10.3978/j.issn.1000-9604.2015.06.07
17. Кованов В.В. Оперативная хирургия и топографическая анатомия. 4-е изд., доп. М.: Медицина, 2001 [Kovanov VV. Operativnaia khirurgiia i topographicheskaia anatomiia. 4e izd, dop. Moscow: Meditsina, 2001 (in Russian)].
18. Crist DW, Cameron JL The current status of the Whipple operation for periampullary carcinoma. Adv Surg. 1992;25:21-49.
19. Slezak LA, Andersen DK. Pancreatic resection: effects on glucose metabolism. World J Surg. 2001;25(4):452-60. DOI:10.1007/s002680020337
20. Frey CF, Smith GJ. Description and rationale of a new operation for chronic pancreatitis. Pancreas. 1987;2(6):701-7. DOI:10.1097/00006676-198711000-00014
21. Dominguez-Munoz JE, Drewes AM, Lindkvist B, et al. Recommendations from the United European Gastroenterology evidence-based guidelines for the diagnosis and therapy of chronic pancreatitis. Pancreatology. 2018;18(8):847-54. DOI:10.1016/j.pan.2018.09.016
22. Gupte A, Goede D, Tuite R, Forsmark CE. Chronic pancreatitis. BMJ. 2018;361:k2126. DOI:10.1136/bmj.k2126
23. Büchler MW, Martignoni ME, Friess H, Malfertheiner P. A proposal for a new clinical classification of chronic pancreatitis. BMC Gastroenterol. 2009;9(1):93. DOI:10.1186/1471-230X-9-93
24. Rahman A, O’Connor DB, Gather F, et al. Clinical Classification and Severity Scoring Systems in Chronic Pancreatitis: A Systematic Review. Dig Surg. 2020;37:181-91. DOI:10.1159/000501429
25. Sarner M, Cotton PB. Classification of pancreatitis. Gut. 1984;25(7):756-9. DOI:10.1136/gut.25.7.756
26. Axon AT, Classen M, Cotton PB, et al. Pancreatography in chronic pancreatitis: interational Definitions. Gut. 1984;25:1107-12. DOI:10.1136/gut.25.10.1107
27. Бахтин В.А., Янченко В.А., Прокопьев В.С.. К вопросу о классификации хронического панкреатита. Вятский медицинский вестник. 2009;2-4:4-8 [Bakhtin VA, Yanchenko VA, Prokopyev VS. On the classification of chronic pancreatitis. Vyatka Medical Bulletin. 2009;2-4:4-8 (in Russian)].
28. Буриев И.М., Цвиркун В.В., Глабай В.П., Кочатков А.В. Классификация хронического панкреатита. Анналы хирургической гепатологии. 2005;10(3):67-79 [Buriev IM, Tsvirkun VV, Glabay VP, Kochatkov AV. Classification of chronic pancreatitis. Annals of Surgical Hepatology. 2005;10(3):67-79 (in Russian)].
29. Sarles H. Definition and classification pancreatitis. Pancreas. 1991;6:470-4. DOI:10.1097/00006676-199107000-00015
30. Лысенко И.М. Болезни поджелудочной железы. Охрана материнства и детства. 2012;1(19):64-70 [Lysenko IM. Diseases of the pancreas. Maternal and Child Health. 2012;1(19):64-70 (in Russian)].
31. Ивашкин В.Т., Хазанов А.И., Пискунов Г.Г., и др. О классификации хронического панкреатита. Клиническая медицина. 1990;68(10):96-9 [Ivashkin VT, Khazanov AI, Piskunov GG, et al. On the classification of chronic pancreatitis. Clinical Medicine. 1990;68(10):96-9 (in Russian)].
32. Rossell MC. History of the pancreas and the evolution of concepts and classification of pancreatitis. Rev Gastroenterol Peru. 2002;22(3):243-7.
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33. Shalimov AA, Kopchak VM, Todurov IM, Dronov AI. The diagnosis and surgical treatment of chronic pancreatitis. Annals of Surgical Hepatology. 1998;3(3):7-9 (in Russian).
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35. Gubergrits NB, Khristich TN. Klinicheskaia pankreatologiia. Donetsk: Lebed, 2000 (in Russian).
36. Ramesh H. Proposal for a new grading system for chronic pancreatitis: the ABC system. J Clin Gastroenterol. 2002;35(1):67-70. DOI:10.1097/00004836-200207000-00014
37. Schneider A, Lohr JM, Singer MV. The M-ANNHEIN – classification of chronic pancreatitis: Introduction of a unifying classification system based on revien of previous classification of the disease. J Gastroenterol. 2007;42(2):101-19. DOI:10.1007/s00535-006-1945-4
38. Bagul A, Siriwardena AK. Evaluation of the Manchester classification system for chronic pancreatitis. JOP. 2006;7(4):390-6.
39. Sablin OA, Ilchishina TA. Chronic pancreatitis: classification and possibilities of enzyme therapy. Gastroenterology of St. Petersburg. 2010;1:23-6 (in Russian).
40. Catalano MF, Sahai A, Levy M, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: The Rosemont classification. Gastrointest Endosc. 2009;69(7):1251-61. DOI:10.1016/j.gie.2008.07.043
41. Whitcomb DC; North American Pancreatitis Study Group. Pancreatitis: TIGAR-O Version 2 Risk/Etiology Checklist With Topic Reviews, Updates, and Use Primers. Clin Transl Gastroenterol. 2019;10(6):e00027. DOI:10.14309/ ctg.0000000000000027
Авторы
Е.А. Дубцова*, Л.В. Винокурова
ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия
*DubtsovaEA@zdrav.mos.ru
Loginov Moscow Clinical Scientific Center, Moscow, Russia
*DubtsovaEA@zdrav.mos.ru
ГБУЗ «Московский клинический научно-практический центр им. А.С. Логинова» Департамента здравоохранения г. Москвы, Москва, Россия
*DubtsovaEA@zdrav.mos.ru
________________________________________________
Loginov Moscow Clinical Scientific Center, Moscow, Russia
*DubtsovaEA@zdrav.mos.ru
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