Experts call the pancreas a very tender and unpredictable organ. This is explained by the fact that it is not clear how she will behave in a particular situation during surgical treatment. This is usually done with pancreatitis or with acute organ injury.
Pancreatic surgery is considered one of the most difficult. It differs from others in a large number of deaths.
The prognosis generally depends on the stage of the disease and the general condition of the body, the age of the person. After surgery on the pancreas, a long amount of time is required for the patient to recover and recover.
When is surgical treatment necessary?
This body gives a lot of trouble to specialists both during surgery and after. When removing the pancreas, surgery should only be performed by qualified doctors and only if strictly necessary.
The following diseases can be data for surgical treatment:
- organ trauma;
- frequent exacerbations of chronic pancreatitis;
- malignant neoplasm;
- pancreatic necrosis;
- acute destructive pancreatitis ;
- pseudocysts and chronic cyst.
What can be the difficulties with surgical intervention?
The operation to remove the pancreas causes some difficulties that are associated both with its physiology and with the location and structure of the organ. It is located in an "uncomfortable place." In addition, it has joint blood circulation with the duodenum.
The pancreas is located close to organs such as the kidneys and abdominal aorta, common bile duct, lower and upper vena cava.
The difficulties of surgery in acute pancreatitis are associated with the enzymatic function of the gland. This is explained by the fact that the latter can digest the tissues of the organ itself.
In addition, surgical intervention is fraught with consequences such as fistula formation and bleeding. This can happen due to the fact that the parenchymal tissue of which the organ is composed is very fragile. Therefore, it is very difficult to stitch it.
How is surgery done?
For pancreatic cancer, surgery is also required. The remaining cases in which surgical treatment is necessary were listed above. Also, with a pancreatic cyst, surgery is a mandatory procedure. Surgical treatment is performed under the influence of general anesthesia and muscle relaxants.
If there are symptoms of internal bleeding, then an emergency operation on this organ is required. In other cases, a planned surgical intervention is performed.
So, pancreatic surgery is performed as follows:
- the organ is first opened;
- the stuffing bag is exempted from blood;
- superficial ruptures of the pancreas are sutured;
- hematomas are opened and bandaged;
- in case an organ rupture occurs, stitches are placed on it, and the pancreatic duct is also sutured at this time;
- if the main violations are in the tail of the pancreas, then this part is removed together with the spleen;
- if the head of the organ is damaged, then it is also removed, but with a part of the duodenum;
- Surgical intervention ends with drainage of the stuffing bag.
Some varieties of surgical treatment
In the presence of a pancreatic cyst, surgery involves the removal of the first with part of the organ. As a rule, in this situation, surgery is not considered one of the most difficult.
With stones in the pancreas, surgery begins with dissection of the organ tissue. Also, the duct walls are exposed to this action. After that, the stones are removed. If there are a large number of the latter, then a longitudinal dissection of the organ is performed, followed by the removal of calculi.
It also happens that they diagnose pancreatic cancer. The operation is the most difficult. With a tumor in the tail and body, the gland and spleen are removed. With a malignant neoplasm in the tail and head, the organ is removed along with the duodenum and spleen.
Pancreatic resection - what is it?
This organ is removed partially, but not completely, since a person cannot live without it. This method of treatment is called resection. As a rule, they resort to it with a malignant tumor.
In order to remove the head of the organ, Frey's operation is performed. She is very dangerous and complicated.
Surgical intervention with this method is performed for pancreatic necrosis, an injury in which most of the pancreas is damaged, and for a tumor.
The prognosis after surgery is mixed. Of course, the missing parts of the organ are not restored.
When removing the tail of the pancreas, a favorable outcome is quite possible without digestive disorders and the development of diabetes. But with additional operation of the spleen, there is a high risk of decreased immunity and the formation of thrombosis.
After Frey's surgery, consequences such as infectious complications, bleeding, and damage to nearby nerves and blood vessels are possible.
After surgery, a person has a lack of hormones and enzymes. After all, it was them that were developed by a remote organ. In this case, the patient is prescribed replacement treatment, which allows you to slightly replace the function of the gland.
Pancreas transplant
This operation is very complex. It is not carried out, even if the patient is diagnosed with a tumor of the gland. The latter is very rarely removed. Firstly, surgery is considered very expensive, and secondly, a small percentage of patient survival. Since the pancreas is an unpaired organ, it can only be taken from an inanimate person.
After freezing, the organ can only be stored for about four hours. This is the difficulty in conducting pancreatic transplant surgery.
The placement of a donor organ in its physiological place is difficult. Its transplantation is carried out by moving it to the abdominal cavity and connecting it with the iliac, splenic, and hepatic vessels.
To do this is very problematic, and there is a high probability of death of the patient due to shock and severe bleeding. Therefore, this method of surgical intervention is not practiced.
Tissue of the pancreas is characterized by high antigenicity. And if there is no appropriate therapy, the donor gland will remain only a few days after surgical treatment. Then there will be rejection.
What can be postoperative complications?
As a rule, one of the most common consequences after surgery is postoperative pancreatitis. Symptoms of the development of this ailment will be:
- leukocytosis;
- increase in body temperature;
- rapid deterioration of human condition;
- severe pain in the epigastric region;
- high levels of amylase in the blood and urine.
Acute pancreatitis most often occurs in patients who, after surgery on the pancreas, form an acute obstruction of the main duct. This happens due to organ edema.
Other complications after surgery include exacerbation of diabetes mellitus, peritonitis and bleeding, circulatory failure, pancreatic necrosis and renal-hepatic insufficiency.
What is the essence of postoperative treatment?
Appropriate therapy is prescribed by a specialist after studying the patient’s medical history.
As a rule, after surgery, doctors advise you to adhere to a diet, observe a special gentle regime, eat special enzyme supplements that help digest food.
Also a prerequisite is physical therapy and physiotherapy.
Since after removal of the pancreas most begin to suffer from diabetes, they are prescribed insulin.
Diet after surgery
Clinical nutrition is one of the main components of the rehabilitation period of the patient.
The diet begins after two days of fasting. On the third day, the patient is allowed to eat mashed soups, sugar-free teas, crackers, rice and buckwheat milk porridge, cottage cheese, a little butter and steamed protein omelet.
Before going to bed, the patient can drink a glass of water with honey or yogurt.
The first seven days for the patient, all food should be steamed. After this period, you can eat boiled foods.
Prognosis after surgery
Usually, the fate of a person will depend on the preoperative condition of the patient, the method of surgical treatment, the quality of dispensary events and proper nutrition.
The pathological condition, due to which part of the pancreas was removed, continues to affect the condition of the patient.
With organ resection in cancer, there is a high probability of relapse. If any adverse symptoms are manifested in such patients, you should consult a specialist in order to exclude the process of metastasis.
Physical and mental strain, violation of therapeutic procedures and proper nutrition may not affect the patient’s body in a very good way. It also leads to the development of exacerbations of pancreatic diseases. From the correctness, discipline and exact observance of all the appointments of the surgeon depends on how much and how a person will live.
Pancreatic surgery: patient reviews
Having studied the cases of surgical treatment, we can say that the responses are quite positive. Basically we are talking about malignant neoplasms in the pancreas. Relatives and the patients themselves say that they managed to defeat the disease, despite fears.
Thus, surgical intervention, thanks to the help of qualified specialists, is a kind of lifebuoy for patients.
There are also reviews of people about pancreatic necrosis. As you know, this disease is a neglected case of acute pancreatitis. A large number of thanks to surgeons from the people who helped them survive can be seen on the Internet.
It follows from this that, despite the fact that pancreatic surgery is considered one of the difficult surgical treatments, it helps to get out the sick and continue to work in the same spirit. Just do not forget the number of recommendations and advice that are given by the doctor. And then you will feel like a healthy and full-fledged person.