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CYST & PSEUDOCYST OF 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.

A pancreatic cyst is a closed sac lined with epithelium and located on or in the pancreas. Pancreatic cysts contain fluid.
They can range from benign pseudocysts to malignant cysts (cancerous and potential to spread). There are several different types of pancreatic cysts. Some pancreatic cysts result from certain rare diseases, such as von Hippel-Lindau disease (a genetic disorder).

A pancreatic pseudocyst is a type of cyst that it is not contained inside an enclosed sac of its own with an epithelium lining. They are round or oval in shape and form within a cavity or space inside the pancreas and are surrounded by fibrous tissue. Pancreatic pseudocysts do contain inflammatory pancreatic fluid (particularly the digestive enzyme amalyse) or semisolid matter.

UNDERSTANDING WHO SUFFERS

The cause of most pancreatic cysts is unknown. Some cysts are associated with rare illnesses including von Hippel-Lindau disease, a genetic disorder that can affect the pancreas and other organs.

Pseudocysts often follow a bout of a painful condition in which digestive enzymes become prematurely active and irritate the pancreas (pancreatitis). Pseudocysts can also result from injury to the abdomen, such as from a car accident. Heavy alcohol use and gallstones are risk factors for pancreatitis, and pancreatitis is a risk factor for pseudocysts.

Pancreatic pseudocysts are the most common pancreatic cystic lesions (about 75% to 80% of all pancreatic cystic lesions) and affect approximately 1 in 1,000 adults per year.

POTENTIAL SIGNS AND SYMPTOMS

Pancreatic cysts, including pseudocysts, can be asymptomatic or can produce moderate to severe symptoms. Symptoms may occur within days to months following a pancreatitis attack. When present, the most common symptoms include:

  • Severe, persistent pain in the abdomen and sometimes the back
  • Nausea
  • Vomiting
  • Abdominal bloating
EXAMINATIONS USUALLY REQUIRED

Many pancreatic cysts are found during abdominal scans for other problems.

The main challenge in diagnosis is to determine whether the cyst might become cancerous. These procedures are often used to help with diagnosis and treatment planning:

  • Medical history. Previous abdominal injury or pancreatitis might indicate a pseudocyst.
  • Ultrasound, which uses sound waves to detect a pancreatic Pseudocysts, or gallstones that could potentially cause pseudocysts.
  • CT scan. This imaging test can provide detailed information about the size and structure of a pancreatic cyst.
  • MRI scan. This imaging test can highlight subtle details of a pancreatic cyst, including whether it has any components that suggest a higher risk of cancer.
  • EUS (Endoscopic ultrasound). Like MRI, this test can provide a detailed image of the cyst. Fluid can be collected from the cyst during the procedure for analysis to differentiate between types of cysts and pseudocysts and any possible signs of cancer.
  • ERCP (endoscopic retrograde cholangiopancreatography) enables the doctor to view the structure of the common bile duct, other bile ducts, and the pancreatic duct.
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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AFFORDABILITY

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:

Rarely, complications can come from pancreatic cysts/pseudocysts, including:

  • Infection, which can sometimes lead to pancreatic abscess
  • Pseudocyst rupture (breaking open) or hemorrhage (bleeding), which can happen without warning and which can be life-threatening
  • Biliary complications, which can occur when a large cyst blocks the common bile duct, causing skin, mucous membranes, and whites of the eyes to appear yellow (obstructive jaundice)
  • Portal hypertension, or high blood pressure of the splenic vein/portal vein, which requires surgery

Most pseudocysts resolve themselves without treatment, over time. However, when symptoms become persistent, complications emerge, or cysts become larger than 6 centimeters in size, drainage is indicated.

There are three methods of cyst drainage:

  • Endoscopic drainage
  • Percutaneous catheter drainage
  • Surgical drainage: by open, laparoscopic or robotic means.
FURTHER INFORMATION ON INCREASED RISK GROUPS

The best way to avoid pseudocysts is to avoid pancreatitis, usually caused by gallstones or heavy alcohol use. If gallstones are triggering pancreatitis, the gallbladder may need to be removed. If pancreatitis is due to alcohol use, refraining from alcohol can reduce risk. A diet low in carbohydrates and cholesterol and consisting of fresh fruits, fresh vegetables, and lean protein, can lower your triglycerides and help prevent the development of pseudocysts.

Idiopathic chronic pancreatitis is also leading cause of chronic pancreatitis. Hereditary pancreatitis is a rare autosomal dominant disease that causes recurrent painful episodes in childhood, leading to chronic pancreatitis and potential pancreatic cancer in adulthood

FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

Blood tests can help determine whether a cyst is benign (noncancerous) or precancerous:

  • CA19-9: This test measures the level of a protein in the blood or cyst fluid that may be higher if a cyst is precancerous. The test isn’t precise, however, since the CA19-9 level can rise in response to noncancerous conditions such as pancreatitis.
  • Carcinoembryonic Antigen (CEA): This test measures the amount of the protein in the blood or (better) from fluid taken from a pancreatic cyst during an endoscopic ultrasound. Results may help in determining if a cyst is precancerous.
  • Liver (hepatic) function: This test measures the level of a waste product created in the liver called bilirubinlevels of liver enzymes that can rise when a cyst or tumor blocks the bile duct.

Biopsy: in addition to blood tests and imaging tests, a biopsy may be undertaken. This test involves taking a sample of the pancreatic cyst tissue to examine carefully. A biopsy is done at the same time as an endoscopic ultrasound.

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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