SURGERY FOR PANCREATIC DISEASES
The pancreas a long, flat gland that sits tucked behind the stomach in the upper abdomen. It plays a role in the digestive and endocrine system and is an important organ. Surgery for pancreatic conditions addresses either tumours of the pancreas (both malignant and benign) or as a treatment for acute or chronic pancreatitis. Acute pancreatitis is a sudden inflammation of the pancreas that lasts for a short time while chronic pancreatitis is more long-lasting and usually occurs due to damage done by heavy alcohol use.
Pancreatitis is inflammation in the pancreas due to damage done by the digestive enzymes becoming active before they leave the pancreas and enter the small intestine. This condition of the pancreas causes abdominal pain, swelling, fever, nausea and vomiting.
While mild pancreatitis may go away without treatment, severe cases can be life-threatening leading to complications such as malnutrition due to malabsorption of food, the development of pseudocyst, infection, kidney failure, breathing problems and diabetes. Depending on the type of pancreatic disease, surgery may be done to remove a gallstone in the pancreatic duct, to drain a pancreatic pseudocyst or to remove the tumour or diseased parts of the pancreas.
Reasons for pancreas surgery
- Diagnosis and management of pancreatic diseases
- As treatment for acute and chronic pancreatitis
- Treatment of benign pancreatic cysts (distal pancreatectomy)
- Management of pancreatic pseudocysts
- Removal of a pancreatic tumour (cancer)
This is done through an endoscopic retrograde cholangiopancreatography. This procedure is done with sedation to keep you calm. Your surgeon will then insert an endoscope into your mouth and ask you to swallow it. Once in your oesophagus, the endoscope is moved down to the small intestine, adjacent to the pancreas. Once there, a contrast dye is injected for a special kind of x-ray to be done. This dye will then highlight the pancreatic and bile ducts on x-rays.
Your surgeon can then use the endoscope to remove gallstones. For stones in the duct, a balloon catheter is used to retrieve the stones. Sometimes Dr Kavin will need to remove the stones one by one. After the stones have been removed, your surgeon may want to remove the gallbladder to treat pancreatitis. This is known as a cholecystectomy and can be done laparoscopically through small incisions, minimally invasively.
Resection of the pancreas may also be done for pancreatic cancer. In this case, surgery may be done in conjunction with other cancer treatments by your oncology team to remove (resect) all of cancer or as much as possible. Since it can be hard to stage pancreatic cancer accurately just using imaging tests, laparoscopic surgery may be done to stage pancreatic cancer, and also remove some or all of the tumour.
When done laparoscopically small puncture-like incisions are made into the abdomen. The laparoscope, which is a thin tube fitted with a camera, is inserted so that he may view the pancreas from the inside. A new duct or passageway may be created and attached to directly to the small intestine, or the existing connection between the pancreas and small intestine may be widened to treat pancreatitis and allow drainage from the pancreas. Any diseased or dead tissue may also be removed at the same time.
After an endoscopic retrograde cholangiopancreatography, you may need to remain in the hospital for a few hours until the sedation has worn off. If your gallbladder was removed or the pancreas was resected, you would have been put under general anaesthesia and would thus need to stay for observation for a few days. You may feel bloated or nauseous when you wake up, but this should go away in a few hours of surgery.
Operating from the new state-of-the-art, multi-disciplinary facility equipped with only the most advanced medical technology,
As one of only two such robots in the Western Cape, Dr Kavin operates from a hospital boasting Robotic Surgery capabilities,
As a surgeon with adept skill in minimally invasive techniques, Dr Kavin opts for laparoscopic keyhole surgery whenever possible.
Dr Bruce Kavin is a General Surgeon with particular expertise in Endocrine, Colorectal and Gastrointestinal Surgery and Surgical Oncology.