— by Cate Stevenson, BA
Your pancreas — you know the organ’s name of course, but likely couldn’t tell anyone much about the organ itself. You might know that the pancreas plays a role in producing insulin. But it has another pretty important job to do as well.
Your pancreas is about six inches long. It is attached to the muscles and tissues near your back. Your pancreas actually has two very different roles and has different parts to carry out these tasks. Along with helping to produce insulin, the pancreas also helps to digest food. When food hits the first part of your small intestine, special cells in your pancreas squeeze out juices to digest food so it can be absorbed in the small intestine. This pancreatic juice also neutralizes the strong acids from your stomach so they don’t damage your intestine downstream. When someone suffers from pancreatitis, he or she probably has a block in the pancreatic duct. When this happens, these powerful chemicals spill over and literally digest the pancreas itself.
When a person has a dangerously inflamed pancreas as the result of pancreatitis, doctors often operate to cut away dead tissue in an effort to save the pancreas. However, the difficulty is that it can be hard to see where dead tissue ends and healthy tissue begins. And the more tissue there is that is removed, the greater the chance for complications such as diabetes. Not surprisingly, a new study suggests that minimal surgery may be the better approach.
The study, involving 88 volunteers, was designed to see if a series of less extreme steps would be as effective in treating pancreatitis. The research team found the rate of major complications was 69% for patients who had surgery right away. Among those who had pus drained as the first step in treatment, followed by less aggressive surgery if necessary, the complication rate dropped to 40%. This initial infection-fighting step is an easy technique that any radiologist can perform and it leaves more healthy insulin-producing cells, so patients are less likely to develop diabetes, the researchers say.
The researchers also found that 16% of the patients receiving step-by-step care developed diabetes soon after treatment, compared to a much larger 38% who had traditional surgery. The research team concluded that a more gradual approach — first draining pus from the pancreas and later surgically removing loose tissue, if necessary — produces fewer complications without increasing the risk of death.
It is estimated that about 233,000 people are hospitalized with acute pancreatitis each year.