Pancreas Surgery

Pancreas Surgery

What exactly is the Pancreas?​

The pancreas is an organ that serves multiple functions, including the release of endocrine hormones and digestive enzymes. Abnormal growths in the pancreas often require surgery. Occasionally, complications from pancreatitis require surgical management as well.

Diseases of the Pancreas

Cystic disease of the pancreas is a common finding. Often, patients do not have symptoms and the cysts are found incidentally during imaging. Some cysts are benign and require no intervention. Surveillance imaging is typically indicated. Other cysts may be symptomatic or have a risk of developing into cancer over time and removal is recommended.

IPMN is a unique disease that develops within the pancreatic duct. Specific characteristics can be seen on imaging, such as a dilated duct, that raise suspicion for this disease process. Certain patients with early stages of IPMN can be monitored with surveillance imaging since there is low risk of malignancy. When IPMN reaches a certain size or demonstrates worrisome features on imaging, surgical resection is indicated.

As in other organs, tumors of the pancreas can be benign, low grade, or malignant. In most cases, surgery is recommended to remove the portion of the pancreas containing the tumor, if it has not spread to other organs and is not invading any surrounding structures.

Complications of Pancreatitis

Surgery on the pancreas is rarely indicated for acute pancreatitis itself, but rather may be necessary to treat complications from severe cases. In those cases, a collection of fluid can form around the pancreas, called a pseudocyst. At times, pseudocysts can become symptomatic and cause pain, obstruction, or bleeding. Many pseudocysts will resolve without intervention, but others may require endoscopic or surgical management.

In the most severe cases, pancreatic tissue itself can die off, a process called necrosis. When this occurs, the body may wall-off the area of necrosis and form a collection similar to that seen with a pseudocyst. Like pseudocysts, these may resolve without intervention, but they also may become symptomatic and require endoscopic or surgical management. Some patients may develop an infection in the area of pancreatic necrosis. In these cases, intervention is paramount to healing.

Unfortunately, some patients may develop chronic pancreatitis, causing pancreatic insufficiency and chronic pain. Smoking, alcohol use, and genetic factors can predispose people to the development of chronic pancreatitis. In certain situations, surgery can be an option for management.

Surgery

Surgery on the pancreas is rarely indicated for acute pancreatitis itself, but rather may be necessary to treat complications from severe cases. In those cases, a collection of fluid can form around the pancreas, called a pseudocyst. At times, pseudocysts can become symptomatic and cause pain, obstruction, or bleeding. Many pseudocysts will resolve without intervention, but others may require endoscopic or surgical management.

In the most severe cases, pancreatic tissue itself can die off, a process called necrosis. When this occurs, the body may wall-off the area of necrosis and form a collection similar to that seen with a pseudocyst. Like pseudocysts, these may resolve without intervention, but they also may become symptomatic and require endoscopic or surgical management. Some patients may develop an infection in the area of pancreatic necrosis. In these cases, intervention is paramount to healing.

Unfortunately, some patients may develop chronic pancreatitis, causing pancreatic insufficiency and chronic pain. Smoking, alcohol use, and genetic factors can predispose people to the development of chronic pancreatitis. In certain situations, surgery can be an option for management.

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A medical surgeon who works closely with robot-assisted surgery. Patients are carefully screened before engaging in any pancreatic surgery. Because this technique for surgery is minimally invasive, it is invariably less painful for patients, and it always results in less bleeding, less scarring, and much faster recovery time.