Pancreas

The pancreas is located in the abdomen, tucked behind the stomach. The pancreas has dual roles: it is an organ of the digestive system and of the endocrine (hormonal) system. It is considered as both exocrine and endocrine gland. Pancreas plays an important role in maintaining homeostasis where it produces several digestive enzymes and the hormones that are necessary for controlling blood glucose levels. Once food has been mulched and partially digested by the stomach, it is pushed into the duodenum (first part of the small intestine). The pancreas adds its own digestive juices and enzymes to the food, via a small duct attached to the duodenum. This process is said to belong to the ‘exocrine pancreas.’ The pancreas also produces the hormone insulin, which helps control the amount of sugar in the blood. This is the role of the ‘endocrine pancreas.’

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Pancreatic diseases

Any harm or injury to pancreas may cause several problems. Some of the common diseases of the pancreas

Pancreatitis

Inflammation of pancreas is called as pancreatitis and is of two types, acute and chronic. Acute pancreatitis is sudden and is caused because of gallstones or chronic alcoholism. Chronic pancreatitis occurs when the digestive enzymes attack and destroy the pancreas. Acute pancreatitis that damages pancreatic duct may lead to chronic pancreatitis. The major cause for chronic pancreatitis is chronic alcoholism. It is characterized with abdominal pain, nausea and vomiting. Certain complications of pancreatitis may require surgery. If pancreatitis results from gallstones, cholecystectomy is performed. It is surgical removal of the gallbladder.

In open cholecystectomy, a long incision 5 to 8 inch is made in the abdomen. The incision runs from below the ribs to below the waist.

Laparoscopic cholecystectomy is an invasive technique to remove the gall bladder. Several small incisions are made in the abdomen rather than a large incision. The technique uses a laparoscope, a small thin tube instrument attached with tiny camera and lens that enables to view the inner area on a larger screen.

If certain complications such as enlargement of pancreas, bleeding, pseudocysts, or abscess develop, surgical drainage or repair or removal of the affected tissues may be needed.

Pancreatic Cancer

It is an uncontrolled cell division in the pancreas. Individuals with a habit of smoking, chronic alcoholism and those having diabetes mellitus are at high risk of developing cancer. Chronic pancreatitis if left untreated may cause cancer. Risk of cancer is also high in individuals with a family history of pancreatic cancer. Various diagnostic procedures such as abdominal ultrasound, abdominal computed tomography, percutaneous biopsy, and/or endoscopic biopsy are the performed to diagnose pancreatic cancer. Treatment depends on the stage of cancer and may include chemotherapy, radiation therapy, and/or surgery.

The Whipple procedure is the most common surgical procedure for pancreatic cancer. It is performed for the cancer of the head of the pancreas. In this procedure, the head of pancreas, duodenum, gall bladder and a portion of stomach is removed.

Distal subtotal pancreatectomy is another surgical treatment performed when the pancreatic cancer is in the body or tail of the pancreas. In this procedure, body and tail of the pancreas as well as the spleen is removed.

Cystic Fibrosis

It is a genetic disease where the mucus producing organs and glands produce thick and sticky mucus that block the ducts or openings. In lungs it blocks the airways and causes breathing problems, whereas, in pancreas the pancreatic duct will be blocked so that the digestive enzymes may not reach the small intestine and finally causes digestive problems and malnutrition. The symptoms may vary between the individuals and the most common symptoms include blockade of passage of first stool by bay, breathing problems, severe cough, diarrhoea, salty sweat, and impaired growth. It is diagnosed by sweat test or genetic test. Cystic fibrosis cannot be cured completely. However the treatments improve the longevity. It can be treated with drugs and nutritional supplements. Pancreatic enzyme replacement capsules are taken along with the meal, to replace pancreatic enzymes and help the body convert food into energy. Creon, pancrease, pancreacarb, cotazym, and ultrase are common pancreatic enzyme medications.

Diabetes

Pancreas produces insulin, a hormone that breaks up glucose. Deficiency of this hormone causes diabetes mellitus. Diabetes mellitus is of two types, type 1 and type 2. In type 1 diabetes, pancreas loses its ability to make the insulin because the body’s immune system attacks and destroys the cells in the pancreas that produce insulin. In type 2 diabetes because of insulin resistance the insulin produced may not be suffice to meet the needs of thereby increasing the glucose levels in blood.

  • Mater Hospital
  • Sydney Adventist Hospital
  • Norwest Private Hospital
  • FRACS
  • General Surgeons Australia
  • AMA