Prevention of common diseases of the pancreas or interception of their progression is as attractive in theory as it is elusive in practice. The fundamental challenge has been an incomplete understanding of targets coupled with a multitude of intertwined factors that are associated with the development of pancreatic diseases. Evidence over the past decade has shown unique morphological features, distinctive biomarkers, and complex relationships of intrapancreatic fat deposition. Fatty change of the pancreas has also been shown to affect at least 16% of the global population. This knowledge has solidified the pivotal role of fatty change of the pancreas in acute pancreatitis, chronic pancreatitis, pancreatic cancer, and diabetes. The pancreatic diseases originating from intrapancreatic fat (PANDORA) hypothesis advanced in this Personal View cuts across traditional disciplinary boundaries with a view to tackling these diseases. New holistic understanding of pancreatic diseases is well positioned to propel pancreatology through lasting research breakthroughs and clinical advances.

预防胰腺常见疾病或阻止其进展在理论上很有吸引力，但在实践中却难以实现。根本的挑战是对目标的不完全理解以及与胰腺疾病发展相关的多种相互交织的因素。过去十年的证据表明，胰腺内脂肪沉积具有独特的形态特征、独特的生物标志物和复杂的关系。胰腺脂肪变化也已被证明影响全球至少 16% 的人口。这一知识巩固了胰腺脂肪变在急性胰腺炎、慢性胰腺炎、胰腺癌和糖尿病中的关键作用。本个人观点提出的源自胰腺内脂肪的胰腺疾病（PANDORA）假说跨越了传统的学科界限，旨在解决这些疾病。对胰腺疾病的新的整体理解有利于通过持久的研究突破和临床进步来推动胰腺学。