Pancreas is a vital gland, located behind the stomach just below the liver. It produces several digestive enzymes (exocrine function) and also plays a vital role in maintaining the blood glucose levels (endocrine function).
Any disease or injury to the pancreas may cause several problems. Pancreatic surgery comprises a wide range of surgical procedures performed on the pancreas. Most operations involve a resection or removal of the diseased portion of the pancreas. Depending upon the extent of the resection it may have an effect on the exocrine and endocrine function. The exocrine part produces enzymes that help in digestion and absorption of nutrients from food. The endocrine part of the pancreas secretes hormones involved in the metabolism of sugar and maintenance of blood sugar levels.
Causes of pancreatic disorder
A pancreatic disorder can be caused by either an acute or chronic pathology.
Any inflammation of the pancreas may temporarily block the bile and the pancreatic duct leading to reflux of the bile into the pancreatic duct. Some of the causes of acute injury to the pancreas include excessive consumption of alcohol, certain medications, viral infections such as mumps, also hypothermia and scorpion sting. Alcohol consumption is one of the most common causes of chronic pancreatitis; the other causes of chronic pancreatitis include exposure to industrial toxins, congenital variation in pancreatic duct system and genetic factors. Pancreatic cancer is one of the most common indications of pancreatic surgery.
There are no characteristic symptoms attributed to a disorder of the pancreas.
The symptoms are usually generic and may include sharp, aching or burning pain over the upper and central portion of the abdomen associated with back pain. Any enlargement or abnormality of the head of the pancreas may block the bile duct and lead to jaundice associated with dark urine, pale stools and itchy skin. Streatorrhoea is a condition characterized by loose, pale, fatty, floating, offensive bowel motions due to lack of secretion of the digestive juice from the pancreas (exocrine function) that hampers the absorption of fats from the intestines. Pancreatic disorders may interfere with digestion and sugar metabolism and the patient experiences weight loss and loss of appetite.
Some of the commonly performed pancreatic operations include pancreatico-dudenectomy (Whipple’s procedure), distal pancreatectomy, pancreatic bypass, pancreatic necrosectomy, and drainage of pseudocysts.
Depending upon the indication for surgery, the type of operation will differ. A/Professor Adam Bartlett will explain this at the time of your consultation.
Pancreatico-dudenectomy, more commonly referred to as Whipple’s procedure, is the most common pancreatic surgery indicated for the removal of tumors from the head of the pancreas. Distal pancreatectomy involves resection of the tail and body of the pancreas, leaving the head. Pancreatic bypass is a palliative operation, that is rarely performed, to bypass an obstructing tumour located within the head of the pancreas. Pancreatic necrosectomy is usually performed in an acutely unwell patient with severe acute pancreatitis. Drainage of pseudocysts is a surgical procedure performed in patients with a collection of inflammatory fluid around the pancreas as a consequence of acute pancreatitis. It is usually performed endoscopically using EUS.