Pancreatic Surgery

The pancreas is a small but vitally important organ that lies across the back of the abdomen. Pancreas makes enzymes (digestive juices) that are released into the intestines (gut) and participates in the digestion of nutrients and its absorption. Pancreas is responsible for controlling sugar metabolism and its levels in our blood by secreting hormones. The inflammation of pancreas is known as “pancreatitis. There are two types of such inflammations “acute” and “chronic”. Acute pancreatitis causes sharp, aching pain in the central or upper part of the abdomen associated with back pain. In chronic pancreatitis recurring inflammation and its progression damage the pancreas. Symptoms usually include abdominal pain, jaundice, weight loss, changes in the bowel motions including frequency, and loose pale stools. In advanced chronic pancreatitis, surgery is the only option.

Steps taken

The surgical intervention includes either by removing part of the pancreas, or by draining the pancreatic duct and surrounding inflamed tissue. Efforts are made to avoid removing other surrounding organs such as the stomach and duodenum to help maintain possible normal digestive functions. This is a major surgery assisted by team of specialists and conducted under general anaesthesia. The part of diseased pancreas are surgically removed, the cut parts are stapled and joined back. Special dressings are used at the incision sites for healing and protecting from exposure for any infections. Some surgical drainage tubes left in the abdomen so that post-operatively regular monitoring for healing and drainage can be monitored by the surgical team.

Recovery from pancreatic surgery is a long process of almost 2 months. Patient spends an average of 5-15 days in the hospital after the surgery. Patient will be maintained on proper hydration through the hospital stay and on liquid diet. The discharge is not advised until patient is able to tolerate food and liquid. Patient needs to visit regularly until the full-recover and thereafter for regular check-up. In case of pancreatic cancer, CT scans are taken to ascertain any new lesions or growth. so that proper treatment can be given. After the recover from the surgery, in pancreatic cancer cases, adjuvant chemotherapy is recommended. Blood tests for tumours are also performed periodically and in case of any doubt during the follow up clinical examinations.

Precautions

Pancreatic surgery is a major and delicate surgery and there are possibilities of many unresolved medical issues. bleeding, excessive drainage, fever due to infections, vomiting, intolerance to food are concerns in these cases. Upon discharge, the diet recommendations must be completely followed to avoid complications. Nausea, heartburn and vomiting is common. This is called as “gastric ileus”. It takes several weeks for the gastric tract to return to normal.

Most patients who undergo surgery for pancreatic cancer will also require a course of chemotherapy after their operation, known as adjuvant chemotherapy. Adjuvant treatment does not normally start until six to eight weeks after surgery.

Advantages

The pancreatic surgery helps in permanent pain relief. In few patients the pain may recur if the pancreatitis has progressed to the remaining pancreatic tissues.

FAQs

What are the early signs of pancreatitis?

Weight loss is common with most pancreatic disorders because of the interference with digestion and sugar metabolism. Patients also get a loss of appetite with some pancreatic diseases.

Can pancreatitis lead to diabetes in a patient?

Diabetes can be caused by pancreatic failure, it is usually characterised by weight loss, lethargy, thirst, blurred vision, increased volumes of urine and drowsiness.

Can the patient with pancreatitis consume alcohol?

It is advised to avoid alcohol completely. Patients with alcohol-related chronic pancreatitis run a serious risk of continuing damage to the pancreas, repeated attacks of pain, and increased difficulty in managing other complications such as diabetes.

Is there a definite recovery period following pancreatic surgery?

Every patient has its own health status and ability to bounce back; hence the recovery periods for each patient are different although they have undergone the same procedure. The usual recovery period is 2 months following the surgery and provided there are no intermittent complications.

Can my diabetes worsen after the pancreatitis?

Yes; there is a possibility of worsening of diabetes. However, appropriate treatment will be available to control diabetes.

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