外科格言与引语集萃（67）
------ 胰腺之二
图/文 余小舫
1,Acute pancreatitis is the most terrible of all the calamities that occur in connection with the abdominal viscera.
----- Berkeley Moynihan, 1865-1936
【中文】急性胰腺炎是所有腹腔脏器相关祸患中最可怕的。
2，It is fascinating to conjecture how an inflammatory process in a retroperitoneal gland can produce abnormalities in so many other organs.
------ Reginald Fritz，1843-1913
【中文】推测腹膜后这个腺体的炎症是如何引发如此多其它器官的异常是件很有趣的事。
【点评】100多年过去了人们依然继续在推测。
3,The most common errors in the surgical treatment of acute pancreatitis are to operate too early in the course of the disease, and to do too much, or in the secondary or septic phase of the disease, to operate too late and to do too little.
-----Kenneth W. Warren, 1911-2001
【中文】急性胰腺炎外科治疗中最常见的错误要么是在病程中过早手术，做得太多，要么是在疾病的继发或脓毒血症期，手术太晚，做得太少。
【点评】或许正是由于这一新的认识才奠定了近20年来急性胰腺炎外科治疗新模式的基础。
4，Acute necrotizing pancreatitis: during the early phases of the disease "our patience will achieve more than our force" (Edmund Burke. 1820-1895); later on . when called to operate on necrotic and infected complications, remember that "patience and diligence, like faith,//www.58yuanyou.com remove mountains" (William Penn)
----- Moshe Schein
【中文】急性坏死性胰腺炎：在疾病的早期阶段，“能让我们收益更多的是耐心而不是魄力”（埃德蒙伯克，1820-1895）；后期，当被要求对坏死和感染并发症进行手术时，请记住“除了耐心还要肯下功夫，要有移山的信念”（威廉佩恩）。
5,Do not treat severe acute pancreatitis with daily CT scans.
---- Sai Sajja
【中文】治疗重症急性胰腺炎用不着每天做CT扫描。
【点评】目前，的确有些医院急性胰腺炎患者的CT扫描做得过于频密。
6,White wine causes pancreatitis. Red wine, cirrhosis.
-----Maurice Mercadier, 1917-2002
【中文】白葡萄酒引发胰腺炎，红葡萄酒导致肝硬化。
【点评】无论何种酒都不是个好东西，神奇的是数百年来人们依然与之纠缠不清。
7,Whether you will develop severe pancreatitis or not depends on the quality www.58yuanyou.comof what you drink and the amount of zakuski you consume.
-----A Russian surgeon
【中文】你是否会发展成重症胰腺炎取决于你所饮酒的品质和你吃了多少冷盘菜。
【注】扎库斯基（Zakuski）是俄罗斯和其他后苏联国家聚会或招待会上常见的餐前开胃菜，通常包括由抹鱼子酱的小三明治、烟熏香肠及各种腌制蔬菜等拼成的冷盘，并且都与冰镇伏特加或其他酒精饮料一起上桌。
8,For pancreatic trauma: treat the pancreas like a crawfish, suck the head ... eat the tail.
----- Timothy Fabian
【中WezbRd文】处理胰腺损伤：应该像吃小龙虾一样，吸头吃尾。
【点评】第一次听到这样的比喻，形象易记---受损的头侧放置引流管，尾侧可以切除，或者做内引流。
9,Ductal adenocarcinoma of the pancreas is an incurable dis//www.58yuanyou.comease.
-----Michael Trede，1928-2019
【中文】胰腺导管腺癌是一种不治之症。
10，The potential for a surgical cure is too often thwarted by our inability to reliably diagnose PDAC at its earliest stages.
----- Jan Mikulicz-Radecki (1850-1905):
【中文】往往由于我们不能准确地早期诊断PDAC（胰腺导管腺癌）而阻碍了手术根治的可能性。
11,Surgeons operating on pancreatic cancer today can be classified into three groups: the ‘aggressive-radical' surgeon who will always attempt major extirpative procedures with resection of major vessels and vascular reconstruction; the 'nihilist-timidWezbRd' surgeon who avoid getting involved in complex time-consuming risky procedures; and the 'rational' surgeon who will tailor the operation to the stage of the disease, and the patient's general condition and ability to tolerate the operation.
-----Jackie T. Tracey & Abdool R. Moosa
【中文】今天的胰腺癌手术外科医生可以分为三类：一类是“激进根治”型，他总是试图通过切除大血管和血管重建来进行大范围根治性切除手术；另一类是“虚无主义—胆小”的外科医生，他远离复杂而耗时的危险手术；以及“理性的”外科医生，他们会根据疾病的阶段，以及患者的全身情况和手术耐受力来调整手术。
