Pancreatectomy!!??

Question

I was recently hospitalised with acute pancreatitis; my doctors says it is necessary to perform pancreatectomy in order to improve my pancreatic drainage? Is invasive surgery the only option?

Answer 1

A little knowledge is a dangerous thing isn't it? The first three guys seem to have some medical background but obviously have no clue about the surgical management of acute pancreatitis.
If you had acute pancreatitis then the indication for surgery would be the presence of infected pancreatic necrosis, a pancreatic abscess or a pseudocyst of the pancreas.
Infected pancreatic necrosis requires surgical necrosectomy but if you had infected pancreatic necrosis then you would be struggling in a surgical ICU, not asking questions on Yahoo.
If you have a pancreatic abscess then you need drainage of the abscess or abscesses. This may be done percutaneously using ultrasound or CT guidance but if the abscess contents are semisolid or there are septations in the abscess then this might not work and surgical drainage may be required.
If you have a pseudocyst of the pancreas then there is an option of endoscopic cystoduodenostomy or cystogastrostomy if the location is anatomically suitable.
Diabetes is unlikely since we rarely have to remove the entire pancreas.

Answer 2

A lot depends on how much scarring there was of your pancreas, actually; if the pancreatic ducts are scarred badly enough to impair drainage, you might need a Roux-en-Y type procedure to establish an alternative drainage.

Now, if you've got large scale cyst formation in the pancreas (an occasional occurrence with sufficiently severe pancreatitis) there may need to be surgery to get rid of the cyst before it becomes infected, which is a really ugly mess: seen one or two of those that got infected, and it was totally ugly, believe me.

On the whole, though, a pancreatectomy is removal of the pancreas (possibly only part thereof); I'm not sure that's what they're talking about doing, in all honesty. It might be a good idea to get a second opinion, from another group specializing in digestive diseases (Gastroenterologist, the discipline being gastroenterology) and see what they have to say. They may have another option to offer, and if they say the surgery is necessary, then you've got confirmation of the original opinion, and I'd go with it.

Not a totally satisfactory answer, but the best I can do with the limited data I've got here.

Answer 3

If your pancreas got infected and had necrosis or if there is diagnostic uncertainty and complications, invasive surgery would be the only option. If the infection is just mild, then you may receive extensive antibiotics course. If the infection is severe ( can have necrosis) still you will be covered with antibiotics to combat sepsis though use of antibiotics on such stage remain controversial. Vinay K has given an adequate explanation. Surgery would be done to remove part of the pancreas affected, not the entire pancreas. Pancreas has a very important role to play in your body so all care will be done to save as much of its part. So far, the researches results revealed that for the time being surgery is so far the best option in managing infected pancreatic necrosis. Performing surgery would remove the affected part of the pancreas to stop further spread of infection and necrosis otherwise the pancreas may end up totally necrotized which would lead to various severe complications.

Answer 4

Yes, consider seeking a second opinion. Also, by removing the pancreas you will become an insulin dependant diabetic. If a pancreatectomy is necessary, ask if your docs can harvest your islet cells - those cells that produce insulin - and implant them in your liver. This can eliminate or lessen insulin need.

If they cannot do this, ask for a referral to a medical center where it is done. The procedure has been available for about 10 years. But I am assuming your pancreas still contains viable islet cells.

Answer 5

Surely is NOT a pancreatectomy: this means removing your pancreas, and you cannot live without it.
You probably mean "pancreatostomy", which is opening a route for evacuation.
In the last 10 years, methods involving ascending endoscopy have become very succesfull, without surgery.
I would make sure you contact, not a surgeon, but a GI specialist, to get a second opinion.

Answer 6

im not a professional so i would not know?! but u should visit nhs if u live in UK i think there website might be able to give u the required info u need. hope this helps!
good luck