The pancreas and its functions
The pancreas is a vital organ that performs two main functions:
- Exocrine function: Produces digestive enzymes that help break down food
- Endocrine function: Produces hormones like insulin that regulate blood sugar
When a tumor develops in the pancreas, these functions may be affected, which has important implications for both diagnosis and treatment.
Types of pancreatic cancer
Pancreatic ductal adenocarcinoma
- The most common type (85-90% of cases)
- Originates in the ducts that carry digestive enzymes
- Usually more aggressive and diagnosed late
Pancreatic neuroendocrine tumors
- Less common but generally better prognosis
- Originate in hormone-producing cells
- Can be functioning (produce hormones) or non-functioning
Symptoms of pancreatic cancer
Symptoms may include:
- Abdominal pain radiating to the back
- Unexplained weight loss
- Jaundice (yellowing of skin and eyes)
- New-onset diabetes
- Changes in bowel movements
- Nausea and vomiting
Important: Many symptoms appear when the disease is advanced, so it is crucial to consult about any persistent symptom.
The Whipple Procedure (Pancreaticoduodenectomy)
The Whipple procedure is a complex surgery that represents the standard treatment for tumors located in the head of the pancreas.
What does this surgery involve?
During the Whipple procedure, the following are removed:
- The head of the pancreas (where the tumor is located)
- The duodenum (first part of the small intestine)
- The gallbladder
- Part of the common bile duct
- In some cases, part of the stomach
Surgical reconstruction: After removal, it is necessary to reconstruct the digestive tract by connecting the remaining pancreas, bile duct, and stomach to the small intestine.
Preparation for surgery
Complete preoperative evaluation:
- Detailed imaging studies (CT, MRI)
- Cardiac and pulmonary function evaluation
- Nutritional analysis and optimization
- Liver function evaluation
- Psychological preparation and patient education
Optimizing general condition:
- Diabetes control if present
- Treatment of jaundice if present
- Improvement of nutritional status
- Preoperative respiratory physiotherapy
Duration and hospitalization
- Surgery duration: 4-8 hours depending on complexity
- Hospitalization: 7-14 days on average
- Full recovery: 2-3 months
Possible complications
Pancreatic fistula
This is the leakage of pancreatic juice from where the pancreas is connected to the intestine.
Management:
- Abdominal drains
- Dietary control
- Medication to reduce pancreatic secretion
- In severe cases, may require reoperation
Most resolve with conservative treatment within weeks to months.
Post-surgical diabetes
By removing part of the pancreas, the ability to produce insulin is reduced, which can lead to diabetes development.
Management: May require diet and exercise to oral medication or insulin, with endocrinological follow-up.
Digestive problems
The remaining pancreas may not produce enough digestive enzymes, causing:
- Fat maldigestion
- Large, greasy stools
- Weight loss
Treatment: Pancreatic enzymes with each meal and vitamin supplements.
Dietary adaptation after surgery
- Small, frequent meals
- Initial fat reduction
- Vitamin supplements (A, D, E, K)
- Specialized nutritional follow-up
Long-term follow-up
Regular check-ups include:
- Pancreatic function (enzymes, blood sugar)
- Nutritional status
- Early detection of recurrence
- Quality of life
A message of hope
Pancreatic surgery is complex, but advances in surgical technique and perioperative care have significantly improved outcomes. With proper follow-up and gradual adaptation, many patients achieve a good quality of life after the procedure.
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