”The pancreas was apparently discovered by Herophils, a greek surgeon in 300 BC. But its name was coined 400 years later by Ruphos, the word pancreas meaning “ all flesh”(Greek pankreas: pan-, pan- + kreas, flesh)
Yes…..it’s a flesh-like soft organ, initially thought to be acting like a cushion to protect huge blood vessels of the abdomen, but later found to contribute to major functions in the digestive process as well as blood glucose level regulation mechanisms.
There was a time when pancreatic surgery was a nightmare for surgeons. This was due to the fact that the chance of bleeding and leak during and after surgery was high following pancreatic operations leading to major catastrophes and even death. But over the years, surgeons learned to handle the pancreas with extreme care bringing down the death rate and other eventualities.
Surgery of the pancreas may have to be undertaken for two major reasons.
1. Inflammation of the pancreas
2. Cancer or Potentially cancerous lesions of pancreas
Inflammation of the Pancreas: Otherwise known as pancreatitis, inflammation can be
1. Acute, the major cause can be alcohol use, toxins or even gallstones.
2. Chronic, the major cause being chronic use of alcohol.
In some tropical areas, chronic pancreatitis is prevalent and food habits or genetic changes have been attributed as the cause.
Acute pancreatitis can be severe enough to endanger life and in extreme situations, surgery may be mandatory to remove the infected, devitalized parts of the pancreas. Keyhole surgery with magnified vision is the new tool in the armamentarium to tackle such a situation.
In Chronic pancreatitis, the soft gland becomes tough and harder with stones embedded in it. Early-onset diabetes with recurrent pain is the hallmark of such a condition.
Persisting abdominal pain above the navel associated with back pain, not relieved with analgesics is an indication for surgery in chronic pancreatitis. Many types of surgeries for the drainage of the pancreatic duct as well as the removal part of the pancreas have been described to tackle such situations. Laparoscopy or Minimally Invasive Surgery can be utilized in these cases to reduce the pain and incapacitation related to the surgery and hospital stay.
Cancer or Potentially cancerous lesions of the pancreas:
Early pancreatic cancers often do not express any symptoms. By the time they do cause symptoms, they would have often grown very large or already spread outside the pancreas.
Pancreatic head resection surgery otherwise called Whipple’s surgery is a major sophisticated surgery that requires a lot of expertise and experience. The complication rate of such surgeries can be up to 20%. There are only a few centers in India that adopt Keyhole surgery (laparoscopic surgery) for such a major surgical procedure which is technically more demanding and requires skill and expertise.
Removal of the tail portion of the pancreas is otherwise named as Distal pancreatectomy. This also can be done by laparoscopy by experienced hands.
In summary, though pancreatic surgery is associated with dreaded complications, the Safety of surgery can be improved with experience, technological support, and teamwork.