Pancreatitis
Pancreatitis is inflammation of the pancreas. This happens when digestive enzymes start digesting or attacking the pancreas itself. The pancreas is a large gland that is about six inches long and sits behind the stomach and near the duodenum (the first part of the small intestine). The pancreas secretes enzymes into the duodenum. These enzymes join with bile to digest food. The pancreas also releases the hormones insulin and glucagon into the bloodstream to help the body regulate glucose taken from food for energy. Normally, digestive enzymes do not become active until they reach the small intestine. But when the pancreas is inflamed, the enzymes inside it attack and damage the pancreas. Severe pancreatitis can lead to bleeding, infection, and permanent tissue damage. Pancreatitis can be acute or chronic.
Acute pancreatitis comes on suddenly and usually goes away in a few days with treatment. Acute pancreatitis can be a life-threatening illness if there are severe complications. Chronic pancreatitis is inflammation of the pancreas that does not heal or improve can lead to permanent damage. Chronic pancreatitis, like acute pancreatitis, occurs when digestive enzymes attack the pancreas and nearby tissues, causing episodes of pain.
Symptoms - Most people with chronic pancreatitis experience upper abdominal pain, although some people have no pain at all. The pain may spread to the back, feel worse when eating or drinking, and become constant and disabling. In some cases, abdominal pain goes away as the condition worsens, most likely because the pancreas is no longer making digestive enzymes. Other symptoms may include:1
- Nausea
- Vomiting
- Weight loss
- Diarrhea
- Oily stools
Causes & Risk Factors
Chronic pancreatitis often develops in people who are between the ages of 30 and 40. The most common cause of chronic pancreatitis is many years of heavy alcohol use. The chronic form of pancreatitis can be triggered by one sudden attack that damages the pancreatic duct. The damaged duct causes the pancreas to become inflamed. Scar tissue develops and the pancreas is slowly destroyed.
Other causes of chronic pancreatitis include:
- Hereditary disorders of the pancreas
- Cystic fibrosis
- Hypercalcemia (high levels of calcium in the blood)
- Hyperlipidemia or hypertriglyceridemia (high level of blood fats)
- Certain medicines
- Certain autoimmune conditions
- Gender (men are at higher risk)
Treatment
Treatment for chronic pancreatitis may require hospitalization for pain management, IV fluids, and nutritional support. A feeding tube may be needed for several weeks if weight loss continues. When a normal diet resumes, the doctor may prescribe synthetic pancreatic enzymes if the pancreas does not secrete enough of its own. Patients are often given nutritional and lifestyle counseling which focuses on: a low fat diet, plenty of fluids, limited caffeinate and no alcoholic beverages, or smoking.
When pancreatic tissue is destroyed in chronic pancreatitis and the insulin-producing cells of the pancreas have been damaged, diabetes may develop. People with a family history of diabetes are more likely to develop the disease. If diabetes occurs, insulin or other medicines are needed to keep blood glucose at normal levels. A health care provider works with the patient to develop a regimen of medication, diet, and frequent blood glucose monitoring.
Surgery
Chronic pancreatitis also can lead to calcification of the pancreas, which means the pancreatic tissue hardens from deposits of calcium salts. Surgery may be necessary to remove the affected portion of the pancreas. If the bottom half or tail of the pancreas is hardened and needs to be removed, this surgery is known as distal pancreatectomy.
With traditional open surgery, a large incision is made to access the pancreas and nearby organs. Open surgery is highly invasive and typically requires a longer hospital stay and recovery than less invasive surgical options. Laparoscopic distal pancreatectomy is considered a safe and effective alternative to open surgery. During laparoscopic surgery, doctors make small incisions, use long-handled instruments and a tiny camera to perform the operation. There are inherent limitations to laparoscopic surgery due to the rigid instruments used, particularly for very complex and delicate operations.
da Vinci® Surgery for Pancreatitis
If your doctor recommends surgery to treat a disease affecting your pancreas, such as chronic pancreatitis, you may be a candidate for safe, effective and minimally invasive da Vinci Surgery.
Using the most advanced technology available, the da Vinci Surgical System enables your doctor to perform this delicate operation through a few tiny incisions with breakthrough vision, precision and control. da Vinci Surgery offers patients many potential benefits compared to traditional surgery, including:
- Reduced surgical trauma2
- Greater chance of preserving your spleen3
- Minimal blood loss4
- Shorter hospital stay3
- Fast recovery2
This procedure is performed using the da Vinci Surgical System, a state-of-the-art surgical platform. By overcoming the limits of both traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for people around the world.
As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient, condition and procedure. All surgeries carry risks of major complications. Discuss all treatment options with your doctor because understanding the risks of each treatment can help you make the best decision for your individual situation.
Pancreatic Cancer
Pancreatic cancer is a disease in which cancerous cells are found in the tissues of the pancreas. This disease is also called exocrine cancer. The pancreas is a long gland lying behind the stomach that secretes pancreatic juice into the duodenum (first part of small intestine) and important hormones such as insulin into the bloodstream to help the body regulate the glucose it takes from food for energy.
Symptoms
Pancreatic cancer is hard to catch early because it does not cause symptoms right away. Also, because the pancreas is hidden behind other organs, health care providers cannot see or feel the tumors during routine exams. When you do get symptoms, they are often vague or you may not notice them. They may include:5
- Yellowing of the skin and eyes
- Pain in the abdomen and back
- Weight loss
- Fatigue
Risk Factors
Some risk factors for developing pancreatic cancer include:
- Smoking
- Long-term diabetes
- Chronic pancreatitis
- Certain hereditary disorders v
Treatment
Because pancreatic cancer is often found late and spreads quickly, it can be hard to treat. Possible treatments include radiation, chemotherapy, surgery or a combination of these treatments.
Radiation. Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation uses a machine outside the body to send radiation toward the cancer. Internal radiation uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer.
Chemotherapy. Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into an organ, or body cavity, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer.
- Whipple procedure - The head of the pancreas, gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to produce digestive juices and insulin.
- Total pancreatectomy - The whole pancreas, part of the stomach, part of the small intestine, the common bile duct, gallbladder, spleen, and nearby lymph nodes are removed.
- Distal pancreatectomy - The body and the tail of the pancreas and usually the spleen are removed.
Open surgery to treat pancreatic cancer is highly invasive and typically requires a longer hospital stay and recovery than less invasive surgical options. There are less invasive options available to treat this disease. With laparoscopic distal pancreatectomy, doctors make small incisions, use long-handled instruments and a tiny camera to perform the operation. But, there are inherent limitations to laparoscopic surgery due to the rigid instruments used, particularly for very complex and delicate operations.
da Vinci® Surgery for Pancreatic Cancer
If your doctor recommends surgery to treat pancreatic cancer, you may be a candidate for a safe, effective and minimally invasive procedure - da Vinci Surgery.
Using the most advanced technology available, the da Vinci Surgical System enables your doctor to perform this delicate operation through a few tiny incisions with breakthrough vision, precision and control. da Vinci Surgery offers patients several potential benefits over traditional surgery, including:
- Reduced surgical trauma2
- Excellent cancer control4
- Minimal blood loss2,4
- Fast recovery2
da Vinci Surgery also offers pancreatitis and pancreatic cancer patients key benefits when compared to traditional open or laparoscopic surgery, including:
- Greater chance of preserving your spleen3
- Shorter hospital stay3
This procedure is performed using the da Vinci Surgical System, a state-of-the-art surgical platform. By overcoming the limits of both traditional open and laparoscopic surgery, da Vinci is changing the experience of surgery for people around the world.
As with any surgery, these benefits cannot be guaranteed since surgery is specific to each patient, condition and procedure. All surgeries carry risks of major complications. Discuss all treatment options with your doctor because understanding the benefits and risks of each treatment can help you make the best decision for your individual situation.
1National Digestive Diseases Information Clearinghouse (NDDIC); Pancreatitis. Available from: http://digestive.niddk.nih.gov/ddiseases/pubs/pancreatitis/
2Horgan S, Galvani C, Gorodner V, et al.; Robotic distal pancreatectomy and nephrectomy for living donor pancreas-kidney transplantation; 2007 Transplantation, 84(7), pp. 934-936
3Waters J, Canal D, Wiebke EA, et al. Robot distal pancreatectomy: Cost effective? Surgery DOI 10.1016/j.surg.2010.07.027
4Giulianotti PC, Sbrana F, Bianco FM, et al. Robot-assisted laparoscopic pancreatic surgery: single surgeon experience. Surg Endosc 21 Nov 2009, DOI 10.1007/s00464-009-0825-4
5National Institutes of Health; Pancreatic Cancer. Available from: http://www.nlm.nih.gov/medlineplus/pancreaticcancer.html
While clinical studies support the effectiveness of the da Vinci Surgical System when used in minimally invasive surgery, individual results may vary. There are no guarantees of outcome. All surgeries involve the risk of major complications. Before you decide on surgery, discuss treatment options with your doctor. Understanding the risks of each treatment can help you make the best decision for your individual situation. Surgery with the da Vinci Surgical System may not be appropriate for every individual; it may not be applicable to your condition. Always ask your doctor about all treatment options, as well as their risks and benefits. Only your doctor can determine whether da Vinci Surgery is appropriate for your situation. The clinical information and opinions, including any inaccuracies expressed in this material by patients or doctors about da Vinci Surgery, are not necessarily those of Intuitive Surgical, Inc. and should not be considered as substitute for medical advice provided by your doctor. © 2010 Intuitive Surgical. All rights reserved.
Content provided by Intuitive Surgical. For more information, please visit www.davincisurgery.com
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