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Pancreas is a astland that lies in the upper abdomen behind the stomach. It produces a special digestive juice that help to digest food in the intestines. The pancreatic juice produced by the pancreas drains into the upper intestine (duodenum) through a small tube known as pancreatic duct. The pancreas also produces the hormone insulin which is the most important hormone regulating blood sugar levels in the human body.

Functions of the Pancreas

The pancreas has two major functions :

Exocrine Functions: This is related to the production of pancreatic juice (by the exocrine cells) that helps in digestion of proteins, fats and carbohydrates. In diseases of the pancreas, the production of pancreatic juice is reduced and therefore digestion is affected.

Endocrine Functions : This is related to the production of insulin hormone (by the endocrine cells) which regulates the blood sugar levels in the body. In pancreatic diseases, insulin production is reduced and therefore patient can develop diabetes.

Common problems of pancreas

According to our experts in pancreatic disorders in Dubai, some of the common problems of pancreas that patients suffer from are:

Acute Pancreatitis: This occurs due to sudden inflammation and swelling of the pancreas usually as a result of excess alcohol intake or certain drugs and toxins. It can also occur when a small stone from the gallbladder slips down into the bile duct and blocks the pancreatic duct. The bile duct and pancreatic duct have a common opening into the intestine. Patients with acute pancreatitis develop severe upper abdominal pain that typically goes to the back. It can be associated with distension of the belly and vomiting. While most patients recover with medical management, about 20% patients develop a severe form of acute pancreatitis in which infection develops in the pancreas and other organs like lungs and kidneys also get involved. This is a serious condition and sometimes surgery is required to clean the infection in the pancreas.

Chronic Pancreatitis: This occurs due to ongoing inflammation in the pancreas. It is generally related to alcohol use, genetic defects or unknown reasons. Patients usually have repeated attacks of abdominal pain lasting few days to weeks. Over a period of time they develop poor digestion, weight loss and diabetes. These patients also develop stones inside the pancreas. Some of these patients who have severe episodes of pain can get good relief if pancreatic stones can be removed surgically and the blocked pancreatic duct can be drained properly.

Pancreatic cancer: This occurs in men above the age of 50 and arises from the exocrine cells of the pancreas. It presents with abdominal or back pain, weight loss and jaundice. Pancreatic cancer is quite difficult to detect when it is small. Small pancreatic cancer can be cured by a major surgery known as Whipple’s pancreato-duodenectomy. Our surgery experts in the United Arab Emirates are one of the few in the middle-east region experienced in this surgery. Cure for patients with advanced pancreatic cancer is difficult. Jaundice caused by pancreatic cancer is due to blockage of bile ducts and this can be relieved by special endoscopic procedure – ERCP done by our experts in Dubai.

Neuroendocrine tumours: These are a different type of slowly growing cancers that arise from the endocrine cells of the pancreas. They are known as Gastrinomas, Glucagonomas, and Insulinomas. These are uncommon tumours and patients present with variable symptoms like diarrhea, weight loss, low blood sugars. It requires a detailed evaluation to detect these tumours and plan proper treatment. Our experts in pancreatic diseases have an extensive experience in the management of neuroendocrine tumours of the pancreas. Once diagnosed, these tumours can be removed surgically and patient can be completely cured.

Cystic tumours: Another variety of tumours are cystic tumours. These are slowly growing and form cavities in the pancreas which are filled with thick mucus like fluid. They can cause pain and spread to other parts of the body and therefore need to be removed surgically.

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Difficulties in Treatment of Pancreatic Disorders

As per our gastroenterology and surgery experts in Dubai and U.A.E, despite great advancements in medical science, the diagnosis and treatment of pancreatic disorders is still a difficult task. There are multiple reasons behind it:

  • Pancreas is tucked behind many organs and this makes it relatively inaccessible.
  • It is difficult to see the true condition of pancreatic disorders without surgery.
  • Available imaging studies like CT and MRI scans are not adequate to diagnose the problem correctly.
  • Pancreatic problems do not cause any symptoms and as such it is virtually impossible to detect early disease.
  • Results of diagnostic tests can often be confused with other problems.
  • Surgery for pancreatic cancer is difficult because by the time condition is diagnosed the cancer is advanced
  • Even after removal of pancreatic cancer, relapse rate of is high.
pancreas-duodenum

All these issues make pancreatic disorders a serious challenge for doctors to diagnose and treat. It’s a very complex disease and requires a multi-disciplinary team approach to provide best results for patients.

“Our integrated medical and surgical team in the U.A.E has a huge experience in management of pancreatic diseases. We have the most experienced surgeons in Dubai doing advanced pancreatic surgeries as well as endoscopic treatments like ERCP.”

Endoscopic Ultrasound (EUS)

EUS is a diagnostic modality in which a special endoscope with an ultrasound scanner at its tip is introduced into the stomach and duodenum from where the pancreas can be scanned at a very close distance. EUS is a very important diagnostic tool for the early diagnosis of pancreatitis and pancreatic cancer. Biopsies can also be taken from suspicious lesions seen in the pancreas during the EUS procedure.

ERCP (Endoscopic Retrograde Cholangiopancreatography)

ERCP is an advanced endoscopic technique in which the pancreatic duct can be seen by injecting a dye into it. It helps in early diagnosis of of pancreatitis and pancreatic cancer. It can also be used to treat certain conditions like removal of small stones blocking the pancreatic duct. Sometimes in patients with chronic pancreatitis, a narrowing or stricture develops in the pancreatic duct. A plastic stent can be placed during ERCP to open up these areas of narrowing.

Pancreatic Surgery

Surgery is the sometimes the only way to completely treat pancreatic diseases. Surgery has been conclusively shown to have long term pain relief in chronic pancreatitis. Early pancreatic cancers, neuroendocrine tumours and cystic tumours can be cured if they can be completely removed by surgery. Major surgical procedures undertaken for treatment of pancreatitis and pancreatic tumours are:

Whipple procedure: The Whipple procedure is the most common operation used to treat pancreatic cancer, and involves removing the head of the pancreas, part of the duodenum, stomach and gallbladder. This surgery is one of the most complex abdominal surgeries and should be done only by experts. Our surgical team has a vast experience in this form of surgery.

“Our expert pancreatic surgeons have even performed this surgery laparoscopically by keyhole incisions. Laparoscopic Whipple’s procedure is done by only a handful of surgeons in the world.”

Distal pancreatectomy : A distal pancreatectomy involves removing the tail and body of your pancreas. It can be done laparoscopically and is usually done for small tumours in the tail of the pancreas.

Total pancreatectomy : The whole of the pancreas is removed is removed during this surgery. This is often necessary due to central position of the tumor.

Frey’s procedure: This surgery is done for patients with chronic pancreatitis and severe pain. Usually, in these patients, the major problem is in the head of the pancreas and in the procedure the head region of the pancreas is selectively removed. This causes less complications and faster recovery.

Pancreaticojejunostomy: This is the standard surgery done for patients with chronic pancreatitis and multiple stones in the pancreatic duct. The pancreas is slit apart; all the stones are removed and then the pancreatic duct is longitudinally joined to a loop of the intestine (jejunum). Pain is relived in more than 90 percent of patients after this surgery.

Pancreatic pseudocyst drainage: Sometimes after a severe bout of pancreatitis, fluid collects around the pancreas. This is known as a pseudocyst. When these pseudocysts are big and continues to cause pain, they need to be drained. Drainage of pseudocysts can be achieved either by laparoscopy or by endoscopy.

We are a prominent name in the area of Pancreatic Diseases and Pancreatic Surgery in Dubai and U.A.E. If you wish to get an accurate evaluation or a second opinion regarding any problem related to the pancreas, then our our experienced team of experts in pancreatic diseases will be happy to assist you.