Pancreas: Functions, Enzymes, and Hormones – A Comprehensive Overview

Dual-Gland Organ

The pancreas is a retroperitoneal organ with both exocrine (digestive) and endocrine (hormonal) functions.

Exocrine Function (95% of mass)

• Acinar cells secrete digestive enzymes into duct system → main pancreatic duct (Wirsung) → duodenum.
• Enzymes: Amylase (carbs), Lipase (fats), Proteases (trypsinogen, chymotrypsinogen – proteins), Nucleases.
• Bicarbonate-rich fluid from ductal cells neutralizes gastric acid.
• Activation: Enterokinase (duodenal brush border) converts trypsinogen → trypsin → activates others.

Endocrine Function (Islets of Langerhans, 1–2% of mass)

Clinical Correlates

• Acute/chronic pancreatitis – autodigestion from premature enzyme activation.
• Diabetes mellitus: Type 1 (β-cell destruction), Type 2 (insulin resistance + β-cell failure).
• Pancreatic neuroendocrine tumors (PNETs) – functional (insulinoma, gastrinoma) or non-functional.
• Pancreatic adenocarcinoma – ductal origin; late presentation, poor prognosis.

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Cell Type	Hormone	Action
α-cells	Glucagon	↑ Blood glucose (glycogenolysis, gluconeogenesis)
β-cells	Insulin	↓ Blood glucose (cellular uptake, storage)
δ-cells	Somatostatin	Inhibits insulin, glucagon, GI secretion
PP-cells	Pancreatic polypeptide	Regulates pancreatic exocrine secretion, appetite
ε-cells	Ghrelin	Hunger stimulation