What are Pancreas?
The pancreas is a 6-inch gland located between your spine and your stomach, surrounded by the intestine and liver. Hormones are produced by the pancreas including insulin. The hormones help the body use food energy. The pancreas also produces enzymes the help digest food and are released through a bile duct into the small intestine.
Common Diseases of Pancreas:
Pancreatitis: Disorders Caused by Inflammation
Chronic Pancreatitis: Chronic pancreatitis, associated most often with gallbladder disease and alcoholism, can cause painful attacks over a number of years and lead to other problems, such as pancreatic insufficiency, bacterial infections, and type 2 diabetes.
Acute Pancreatitis: The most common cause of acute pancreatitis is blockage of the pancreatic duct by a gallstone. Secretions can back up in the pancreas and cause permanent damage in just a few hours. They also can circulate to other body organs, causing shock and organ failure. Acute pancreatitis can be life-threatening.
Diabetes Mellitus - Type 1 diabetes involves destruction of pancreatic beta cells (which produce insulin) and a dependence on insulin; type 2 involves loss of some beta cell function and insulin resistance. Diabetes affects many other body organs, especially the kidneys.
Exocrine Pancreatic Insufficiency –Exocrine pancreatic insufficiency is the inability to properly digest food due to a lack of digestive enzymes made by the pancreas. It is caused by a continuous and increased loss of the pancreatic cells that make digestive enzymes. Chronic pancreatitis is the most common cause of Exocrine Pancreatic insufficiency in humans. Loss of digestive enzymes leads to mal digestion and mal absorption of nutrients.
Cystic Fibrosis –Cystic fibrosis affects the internal organs, especially the lungs and digestive system. It causes them to become clogged with thick, sticky mucus. It is caused by a faulty gene that controls the movement of salt and water in and out of cells in the body. When cystic fibrosis occurs, too much salt and not enough water pass into the cells and turn the body's secretions, which normally act as a lubricant, into thick mucus. This mucus clogs up many of the body's tubes, ducts and passageways so they cannot work properly. In the lungs, this leads to frequent and severe infections.
Pseudocysts –Pseudocysts of the pancreas are abnormal collections of fluid, dead tissue, pancreatic enzymes, and blood that can lead to a painful mass in the pancreas. Pseudocysts usually develop several weeks after an episode of acute pancreatitis (a sudden, painful inflammation of the pancreas). Alcoholism also contributes to the risk of pseudocysts of the pancreas. Other, rarer causes include abdominal trauma and gallbladder disease.
Cysts –A pancreatic cyst is a collection of fluid that pools within the pancreas. When the cyst is a true cyst, the pool of fluid is surrounded by a layer of cells that secrete fluid into the interior of the cyst. Most pancreatic cysts cause no disease symptoms and are benign. If cysts grow large, they can cause abdominal pain, back pain or jaundice. In some cases, a cyst can become cancerous.
Pancreatic Cancer –Pancreatic tumors are uncommon but may be either malignant or benign. Malignant tumors in this organ, however, bring with them such a serious prognosis that they are one of the leading causes of cancer death. Pancreatic cancer can sometimes be treated through surgery. The vast majority of tumors is adenocarcinomas and develops from the exocrine cells.
Pancreatic Surgery: The pancreas is a critical organ due to its role in digestive and endocrine function. Surgery for pancreatic conditions addresses either tumors of the pancreas or conditions that cause inflammation also called as pancreatitis. Treatment of a Pancreatic Pseudocyst is to monitor its growth and to treat surgically if it grows, or if there is risk for complications. The treatment may include close monitoring by scans (to determine any change in size) and surgical drainage of the cysts. Cysts with cancer cells or proteins are removed surgically. Cysts without cancer cells or proteins are managed medically. Cystic Fibrosis may lead to various digestive problems and treatment of the same may include enemas and mucus-thinning medicines to treat intestinal blockages. Sometimes surgery is needed to remove an intestinal blockage. Patients with Diabetic Mellitus may undergo various surgeries like Bariatric Surgery, Gastric Bypass Surgery, etc.
The doctor may prescribe medicines to reduce your stomach acid and help oral pancreatic enzymes work better. Pancreatic surgery includes a wide range of surgical procedures related to the pancreas. Most of the surgical procedures which are performed on the pancreas include resection of the portion that is involved in the disease process. Prior to any operation on the pancreas the patient undergoes testing and is evaluated by multidisciplinary team of physicians. The management approaches to acute and chronic pancreatitis are different and may not necessarily involve surgical intervention. Often excellent results can be achieved through medical management. A major pancreatic resection takes approximately 4-6 hours. It is performed without blood transfusion in most cases through Bloodless Surgery. The post-operative hospital stay is about 7 days and complete recuperation time is expected in 6 weeks. In properly selected patients, excellent operative results and future quality of life are achieved.
Preparations for Pancreatic Surgery:
Preparing for an operation can be a confusing process. By informing yourself, you can help ensure that your preparation for surgery can proceed as smoothly as possible. Do not eat or drink anything after midnight on the day of your scheduled operation. This precaution is to prepare your body for the anesthesia. You may take your usual asthma, heart, blood pressure or seizure medication with a small sip of water that morning, unless otherwise advised by your surgery team.
Types of Pancreatic Surgery:
Some of the methods of pancreatic surgery are as follows. The surgeries are used for treating different conditions associated with Pancreas when medical management does not help.
Pancreaticoduodenectomy Or Whipple Procedure -A pancreaticoduodenectomy, also known as a Whipple procedure, involves the removal of the pancreas head due to a tumor in the pancreas or bile duct, or pancreatitis. If a tumor exists in the head of the pancreas, it is usually necessary to remove the pancreas head, duodenum, gallbladder and a portion of the bile duct. Sometimes, part of the stomach
is also removed. The end of a patient's bile duct and the remaining pancreas are then connected to the small bowel to ensure flow of bile and enzymes into the intestines.
Distal Pancreatectomy (Laparoscopic or Open) - Indicated for tumors in the body and tail of the pancreas, a distal pancreatectomy involves the removal of cystic neoplasms either laparoscopically or with open surgery. With both laparoscopic and open distal pancreatectomy procedures, surgeons attempt to preserve the spleen.
Drainage Procedures - With chronic pancreatitis, a dilated pancreatic duct usually reflects obstruction. Procedures to improve ductal drainage include:
Longitudinal Pancreaticojejunostomy (Puestow Procedure) - The pancreatic duct is opened from the tail to the head of the pancreas and attached to the small bowel.
Distal Pancreaticojejunostomy (Du Val Procedure) - The pancreas is divided transversely at the neck, and the body and tail are drained via attachment to the small bowel.
Sphincteroplasty - When endoscopic sphincterotomy is unsuccessful, surgical sphincteroplasty may be required of the minor or major papilla.
Pancreas Transplantation - A pancreas transplant is indicated for patients with insulin-dependent or Type1 diabetes.
Follow – Up Care Post Pancreatic Surgery:
Several days after surgery the patient can go home. You may feel weak and must stay at home for up to one month. Recovery time can vary.
Pain may be felt for a few days following surgery, requiring medicine to manage it.
A liquid diet, or intravenous feeding, may be used for several days until solid foods can be added to your diet.
Patients who have part of their pancreas removed may have difficulty digesting foods. A special diet may help. Side effects can include cramping, diarrhea, and feelings that you are full.
Because the pancreas produces insulin and the enzymes and hormones that your body needs for digestion, removing part or your entire pancreas can decrease the amounts your body needs. Diabetes results from not having enough insulin. The doctor may need to prescribe supplements for insulin, hormones and enzymes.
Benefits of Pancreatic Surgery:
Treatment can be given for different reasons, and the potential benefits will vary depending upon each person's situation. Treatment does have positive results through surgery, radiation or chemotherapy in patients with pancreatic cancer. If diagnosed early, cancer treatments encourage eradication of tumors and cancerous tissues and may increase positive prognosis. Treatment and surgery can help patient receive relief from painful symptoms, thus help them lead a better life. With older age, fewer people with pancreatic cancer undergo surgical resection, even after controlling for comorbidity and other factors.
The study has demonstrated increased resection rates over time in all age groups, along with lower surgical mortality rates. The benefits of pancreas-only transplantation must outweigh the risks of the surgery and life-long treatment with anti-rejection medications (to prevent rejection of the new pancreas). Patients with type 1 diabetes may be considered for pancreas-only transplantation. Laparoscopic cholecystectomy is the gold standard treatment for prevention of further attacks of acute biliary pancreatitis. Recent advances in technology and techniques have opened the gates widely to a wide range of applications of minimally invasive surgery in patients with inflammatory and neoplastic diseases of the pancreas.
Pancreatic Surgery in India:
India is regarded as a leader in surgical quality and management of advanced pancreatic disease as it has achieved high standards of practice in lengths of stay, patient outcomes and patient satisfaction. In India, annually more than thousands of operations are successfully performed. This has placed India among the top medical tourism centers of the world. India has become one of the highest volume pancreatic, hepatobiliary surgery centers as it offers highest acuity pancreatic surgical procedures like Whipple Procedure and some very complex pancreatic resections.
In India there are numerous hospitals available which specializes in different types of cancer treatments including treatment of Pancreatic Cancer. The specialists in these hospitals are well trained in the field of oncology and surgery. India offers several hospitals and medical centers that are known widely for its best medical and health care services in wide variety of specialty fields. The physician and surgeon handle many cases every day and have acquired a skill in operating different difficult and complicated surgeries.
Cities in India offering Pancreatic Surgery at some of the best hospitals are as follows;
Cost of Pancreatic Surgery in India:
Low cost Pancreatic Surgery in India has benefited many patients from all across the globe. Complete treatment including Chemotherapy, Radiation Therapy and some most complicated surgeries are handled very effectively with a cost saving of an estimated 50-70%. The total cost including consultation fee, hospital stay, medicine, surgery, accommodation, transportation, etc can save around 60-80% of the healthcare seeker. This attracts millions of people every year from US, UK and other developed countries.
Some of the common countries from which patients travel to India for surgery are:
Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service.
Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things, including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start exploring this great city.
Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few years. Hyderabad has a well-founded reputation as one of the safest cities in the world.
Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.
Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'. Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as one of the most charming cities in India,
Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good jumping-off point for a series of trips into the far eastern corner of Maharashtra..
Kerala - Welcome to Kerala, state in India's southern tip and a state known as God's Own Country. Kerala is one of the ten 'Paradises Found' by the National Geographic Traveler, for its diverse geography and overwhelming greenery. It is a land much acclaimed for the contemporary nature of its cultural ethos, and much appreciated for the soothing, rejuvenating paradise that it is.
Delhi - Delhi, the capital of India is situated in the northern part of the country. Apart from being the capital of India, Delhi is also the travel hub of northern India. It serves as an excellent base for visiting the colorful state of Rajasthan, and Agra, the city of the Taj Mahal, is less than three hours away. Discover the many tales behind Delhi’s ancient, bewitching existence. Feel the excitement of stepping foot on a piece of the world’s oldest land!
Pune - Pune is the eighth largest city in the India state of Maharashtra. The city derives its name from Punya Nagari, which means 'the city of virtuous deeds.'Pune or the 'Queen of Deccan' is known for its educational, research and development institutions. This beautiful city has many exotic locales attracting innumerable tourists.
Jaipur – Jaipur is located in India and attracts a flurry of tourists from all over the world. Sited within eastern Rajasthan, North India, the city of Jaipur is famed for its hilltop fortresses, magnificent royal palaces and historic pink-painted sandstone architecture, earning it the affectionate nickname of the 'Pink City'.
Chennai - Chennai formerly known as Madras is the capital city of the Indian state of Tamil Nadu. It is famous for its culture and tradition. Chennai hosts a large cultural event, which includes performances by hundreds of artists. The city has a vibrant theatre scene and is an important centre for the Bharatanatyam, a classical dance form.
Gurgaon – It is one of the four important satellite cities of the National Capital Region and is often referred to as the 'Millennium City.' Gurgaon has recently emerged as the latest hub for Medical Tourism. Apart from being IT hub and a favorite haunt for MNC offices, the city has a number of world class hospitals that not only treat Indian citizens but also people from outside.
Chandigarh - Chandigarh is a rare epitome of modernization co-existing with nature's preservation. It is here that the trees and plants are as much a part of the construction plans as the buildings and the roads. India’s first planned city, Chandigarh is a rich, prosperous, spic and span, green city rightly called “THE CITY BEAUTIFUL”.
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