Pancreatic SurgeriesPancreatic problems are some of the most complicated and notorious problems. No all centres and doctors are expert in managing these conditions. The commonly seen pancreatic problems are
It is a condition causing inflammation of the pancreas. The patient usually have very severe upper abdominal pain, back pain and vomiting. We need to get some blood tests to confirm the diagnosis of Acute pancreatitis. The two most common causes of pancreatitis are alcohol intake and Gallbladder stone disease. Of all the patients with Acute Pancreatitis about 70% have mild to moderate pancreatitis, meaning not having any other organ dysfunction. All these patients recover in few days time and usually do not require any surgery or intervention.
But the rest of 30 % have severe pancreatitis, in which part of pancreas gets necrosed (gangrenous) and this affects many other organs of body. These patients become critical with kidney, lung and liver problems and needs ICU care. They may also need intervention or surgery. Patients with severe necrotising pancreatitis usually have a prolonged hospital and ICU stay, may need multiple interventions and surgeries. Despite all these about 5-10% of these patients do not survive. This condition is a huge physical, psychological and financial burden to the patient and their family. As it is difficult to know who will develop severe pancreatitis, all these patients who have confirmed diagnosis of acute pancreatitis should be initially admitted under observation probably in an intensive care unit (ICU). Before 48 hours we cannot confirm that the disease is mild. If after 48 hours the reports shows that there is no involvement of other organs like kidneys, liver and lungs and the patient’s blood pressure and pulse and urine output are normal we can be sure that the disease in mild in nature. For all severe pancreatitis CT Scan of abdomen is done after 4-5 days. Occasionally the disease is very severe leading to haemorrhage and pus in the abdomen and may require immediate operation. For severe pancreatitis each patient responds to treatment in different way and it is not possible to predict the outcome. You need to consult the doctor who is expert in treating these conditions and then have faith in his treatment. We routinely treat these complex problems and fortunately we have achieved excellent results of international standards.
Chronic pancreatitis though a condition of inflammation of pancreas is different from acute pancreatitis. This is not a life threatening condition like acute pancreatitis, but it is a long term problem affecting the quality of life. The patients usually have recurrent pain in the upper abdomen and upper back. The sonography or ultrasound report may show stones in the pancreatic duct. Further test like CT scan or MRI may need to be done. If not treated it may over a period of time cause problems with fat indigestion and diabetes. Such patients have severe diarrhoea with loss of fat in stools. This occurs due to loss of the function of pancreas that produces insulin as well as the enzymes needed for digestion.
If it is affecting you daily life surgery gives a permanent solution to this condition. The surgery is called Frey’s procedure or Pancreatico-jejunostomy. We regularly perform these surgeries on a regular basis with excellent outcomes. You can see the video of one of our patient operated for thee same condition by clicking this link.
Just like other pancreatic problems the cancer of pancreas is also a complex disease requiring expert treatment. The treatment varies depending on the site of tumour in your pancreas and its stage. A thorough evaluation is needed before planning treatment. Surgery is the mainstay of treatment for pancreatic cancers. Some of these can be performed by Laparoscopy, again depending on its location and stage. Some patients may need further treatment in form of chemotherapy after surgery depending on the final biopsy report.