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CHRONIC PANCREATITIS (INFLAMMATION OF THE PANCREAS)

UNDERSTANDING THE PROBLEM

The pancreas is a large gland behind the stomach and next to the small intestine. The pancreas does two main things: It releases powerful digestive enzymes into the small intestine to aid the digestion of food and it releases the hormones insulin and glucagon into the bloodstream. These hormones help the body control how it uses food for energy.

Chronic, or long-term, pancreatitis is an inflammation of your pancreas that impairs your body's ability to digest food and regulate blood sugar. Alcohol abuse is the most frequent cause of chronic pancreatitis, but autoimmune diseases, gallstones, cystic fibrosis, and several other conditions can also cause it.

UNDERSTANDING WHO SUFFERS

Whereas there are causes of chronic pancreatitis that are unknown; several factors have been identified to cause chronic pancreatitis:

  • Heavy alcohol use
  • Autoimmune conditions (when the body’s immune system attacks its own body)
  • Genetic mutations due to cystic fibrosis
  • Blocked pancreatic duct or common bile duct
  • Familial pancreatitis (runs in the family—with 2 or more immediate family members with a history of pancreatitis)

Industrialized countries have estimated an annual incidence rate of 5-12/100,000 people who will develop chronic pancreatitis. The prevalence of chronic pancreatitis is 50/100,000 people. Chronic pancreatitis often develops in patients between the ages of 30 and 40, and is more common in men than women.

POTENTIAL SIGNS AND SYMPTOMS

Most individuals with chronic pancreatitis experience upper abdominal pain, although some have no pain at all. The pain may spread to the back, become worse with eating or drinking, and become constant and disabling. In some cases, the abdominal pain goes away as the condition worsens, but this is fairly uncommon.

Other symptoms include the following:

  • Nausea
  • Vomiting
  • Weight loss
  • Diarrhea
  • Oily or fatty stools
  • Clay-colored or pale stools

Individuals with chronic pancreatitis frequently lose weight, even when their appetite and eating habits are normal. The weight loss occurs because the body does not secrete enough pancreatic enzymes to digest food, so nutrients are not absorbed normally, leading to malnutrition.
Patients who have chronic pancreatitis may have a decreased quality of life due to pain and often require admission to the hospital for treatment of symptoms.

EXAMINATIONS USUALLY REQUIRED

Diagnosis is based on tests of pancreatic structure and function.

Imaging tests
Imaging studies such as abdominal radiography and CT scanning can show inflammation or calcium deposits in the pancreas or changes in the pancreatic ducts. Pancreatic calcifications, often considered pathognomonic of chronic pancreatitis, are observed in approximately 30% of cases.

Endoscopic retrograde cholangiopancreatography
The endoscopic retrograde cholangiopancreatography (ERCP) test provides the most accurate visualization of the pancreatic ductal system and has been regarded as the criterion standard for diagnosing chronic pancreatitis. It combines the use of endoscopy and fluoroscopy to visualize and treat problems of the biliary and pancreatic ducts. See the image below.

This endoscopic retrograde cholangiopancreatography (ERCP) shows advanced chronic pancreatitis. The pancreatogram has blunting of the lateral branches, dilation of the main pancreatic duct, and filling defects consistent with pancreatolithiasis. The cholangiogram also shows a stenosis of the distal bile duct and a dilated biliary tree.

Magnetic resonance cholangiopancreatography
MRCP provides information on the pancreatic parenchyma and adjacent abdominal viscera, and it uses heavily T2-weighted images to visualize the biliary and pancreatic ductal systems. This procedure is relatively safe, reasonably accurate, noninvasive, fast, and very useful in planning surgical or endoscopic intervention.

Endoscopic ultrasonography
The most predictive endosonographic feature of chronic pancreatitis is the presence of stones.

PROPOSING TREATMENT AND WHY AIMIS

Surgery for Pancreatic Disorders

If your doctor recommends surgery for a disorder, you may be a candidate for a minimally invasive approach - da Vinci Surgery. AIMIS is an expert in Robotic Surgery for Robotic Assisted Distal Pancreatectomy, Pancreato-Splenectomy, Resection of the Pancreas Head-Whipple, Spleen preserving Pancreatectomy, Pancreatico-Jejunostomy and other minimal invasive procedures for the Pancreas involving the best American and International surgeons who are experts in the field including:

  • Chronic Pancreatitis ( Inflammation of the Pancreas) - Distal Pancreatectomy, Pancreato-Splenectomy, Resection of the Pancreas Head-Whipple, Spleen preserving Pancreatectomy, Pancreatico-Jejunostomy]
  • Cyst & Pseudocyst of Pancreas - Distal Pancreatectomy, Pancreato-Splenectomy, Resection of the Pancreas Head-Whipple, Spleen preserving Pancreatectomy, Pancreatico-Jejunostomy
  • Pancreas problems (Atrophy, Calculus, Cirrhosis, Fibrosis) - [Distal Pancreatectomy, Pancreato-Splenectomy, Resection of the Pancreas Head-Whipple, Spleen preserving Pancreatectomy, Pancreatico-Jejunostomy]

Explanation of the Different types of Surgery:

  • Distal Pancreatectomy: If the bottom half or tail of the pancreas is affected and needs to be removed, this is known as a distal pancreatectomy.
  • Whipple Pancreatectomy: During the Whipple procedure, the head of the pancreas, most of the duodenum (part of small intestine), gallbladder, part of bile duct, and nearby lymph nodes are removed.
  • Central Pancreatectomy: Performed when there is a benign (non-cancerous) tumor in what is called the neck of the pancreas.
  • Pancreatosplenectomy: Performed to surgically treat pancreatic disease of the tail and body. Distal pancreatectomy involves surgical resection of the body and tail of the pancreas to the left of the superior mesenteric–portal vein confluence, with splenectomy.
  • Spleen Preserving Pancreatectomy: Performed to surgically treat pancreatic disease of the tail and body. Distal pancreatectomy involves surgical resection of the body and tail of the pancreas to the left of the superior mesenteric–portal vein confluence, without splenectomy.
  • Pancreatic Resections: Performed to remove part of the pancreas, the gall bladder, some of the bile ducts and a piece of the smallbowel. Sometimes a portion of stomach is also removed. It is normally, although not always, performed for cancer of the pancreas or of other organs which surround the pancreas
  • Pancreatico-Jejunostomy: The operation involves creating a longitudinal incision along the pancreas while the main pancreatic duct is filleted open longitudinally from the head of the organ to its tail. The duct and pancreas are then attached to a loop of the small intestine (pancreaticojejunostomy), which is oversewn to the exposed pancreatic duct in order to allow its drainage. When used in the appropriate setting, pain from chronic pancreatitis can improve
  • Total Pancreatectomy: A total pancreatectomy is an operation to remove your entire pancreas.

Da Vinci Surgery uses state-of-the-art technology to assist doctors in performing a range of delicate operations for the pancreas and offers several potential benefits over traditional open and laparoscopic surgery, including:

  • Low rate of major complications
  • Low conversion rate to open surgery
  • Virtually scarless surgery
  • High patient satisfaction
  • Minimal pain
  • More precise removal of cancerous tissue
  • Less risk of converting to open surgery
  • Greater chance of saving the spleen (benign cases)
  • Reduced risk of blood loss
  • Shorter hospital stay

To see the procedures we undertake with Robotic Xi Surgery, please click here

GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
  • Can I get more information before I commit to this?
  • Can I get a second opinion from you before I commit to this?
  • How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:

AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.

AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.

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AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.

 

FURTHER INFORMATION ON THE PROBLEM:

Chronic pancreatitis has the potential to cause numerous complications. Continuing alcohol use after diagnosis, increases the risk of developing complications.

Nutrient malabsorption is one of the most common complications. Since the pancreas isn’t producing enough digestive enzymes, the body isn’t absorbing nutrients properly. This can lead to malnutrition.

The development of diabetes is another possible complication. Pancreatitis damages the cells that produce insulin and glucagon, which are the hormones that control the amount of sugar in the blood. This can lead to an increase in blood sugar levels. About 45% of people with chronic pancreatitis will get diabetes. Some people will also develop pseudocysts, which are fluid-filled growths that can form inside or outside of the pancreas. Pseudocysts are dangerous because they can block important ducts and blood vessels. They may become infected in some cases.

FURTHER INFORMATION ON INCREASED RISK GROUPS

In the US approximately 87,000 cases of chronic pancreatitis occur annually If affects men, more than women. The risk for African Americans aged 35-64 years is 3 times higher Alcohol-induced illness is more common in men, idiopathic and hyperlipidemic-induced pancreatitis is more common in women and equal when evaluating chronic pancreatitis associated with hereditary pancreatitis.

Other condition can increase incidence can include: biliary tract conditions, as high triglycerides, trauma, drug-induced etiology, vasculitis and immune system disorder like AIDS, Lupus amongst others. Certain hereditary conditions can also increase risk, such as cystic fibrosis

FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

Occasionally, blood tests, such as a test for IgG4 to assess for autoimmune pancreatitis, can be used to help diagnose the cause of chronic pancreatitis. However, blood tests are not typically used to make the diagnosis of chronic pancreatitis.

They may be used to determine the amount of pancreatic enzymes in the blood.

Blood tests may also be used to check kidney and liver function. Doctors might ask for a stool sample to test for levels of fat. Fatty stools could be a sign that the body isn’t absorbing nutrients correctly.

WHY AIMIS FOR THIS SURGERY

AIMIS is an expert in Robotic Surgery for Robotic Assisted Distal Pancreatectomy, Pancreato-Splenectomy, Resection of the Pancreas Head-Whipple, Spleen preserving Pancreatectomy, Pancreatico-Jejunostomy and other minimal invasive procedures for the Pancreas involving the best American and International surgeons who are experts in the field

Da Vinci Surgery uses state-of-the-art technology to assist doctors in performing a range of delicate operations for the pancreas and offers several potential benefits over traditional open and laparoscopic surgery, including:

  • Low rate of major complications
  • Low conversion rate to open surgery
  • Virtually scarless surgery
  • High patient satisfaction
  • Minimal pain
  • More precise removal of cancerous tissue
  • Less risk of converting to open surgery
  • Greater chance of saving the spleen (benign cases)
  • Reduced risk of blood loss
  • Shorter hospital stay

Some procedures (for example Distal Pancreatectomy and Splenectomy) can be achieved through the belly button traditional single incision laparoscopy or da Vinci® Single-Site® Surgery. The da Vinci System features a magnified 3D high-definition vision system and flexible Single-Site instruments. These features enable your doctor to operate with enhanced vision and precision.

OTHER SERVICES PROVIDED BY AIMIS

In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.

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