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Pancreatitis
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Surgery

Pancreatitis

The pancreas is a gland located in your abdomen. The two main functions of the pancreas is to produce enzymes to aid in digestion of food and to produce hormones like insulin to help maintain blood sugar levels. Pancreatitis is a disease caused by inflammation of the pancreas. At Montefiore Medical Center, our surgeons are experienced in diagnosing and treating all forms of pancreatitis.

Acute Pancreatitis

Acute pancreatitis is a common problem affecting 50,000-80,000 people in the United States each year. Approximately 75 percent of patients experience a mild, self-limiting case and recover without any special treatment. The other 25 percent have severe acute pancreatitis, resulting in a prolonged, complex illness with five to10 percent mortality. Acute pancreatitis is treated by hospitalization, medication, and restriction of food intake.

Chronic Pancreatitis

Chronic pancreatitis develops from progressive scarring and destruction of the pancreas, usually from years of alcohol abuse.

Chronic pancreatitis leads to a number of health concerns:

  • Malabsorption, or poor digestion caused by loss of digestive enzymes from the damaged pancreas and resulting in abdominal pain, weight loss and diarrhea
  • Diabetes from loss of cells that make insulin
  • Pain, often severe and disabling chronic pancreatitis is treated by medication to improve absorption of food, pain control, and occasionally surgery.

Causes of Pancreatitis

The common causes of pancreatitis are gallstones and alcohol abuse. Other conditions are:

  • Medications including Azathioprine, asparaginase, Sodium Valproate, furosimide, tetracyclines, estrogens, sulphonamides, corticosteroids, thiazide diuretics, 6-mercaptopurine, angiotensin converting-enzyme inhibitors, dideoxyinosine
  • Inherited disorders of the pancreas
  • Inherited disorders of fat metabolism (hyperllipidemia)

Recovery does not depend on how or why a patient got pancreatitis. It is, however, important for your doctor to determine the cause of your pancreatitis in order to prevent future attacks.

Symptoms of Pancreatitis

The primary symptom of pancreatitis is pain in the upper or right side of the abdomen or back. Abdominal pain usually develops quickly without warning and is constant. The intensity of the stomach pain varies from mild to severe. Other symptoms include:

  • Nausea
  • Vomiting

It is very important to see a doctor to determine whether or not you actually have pancreatitis. Other causes of abdominal pain that feel like pancreatitis include:

  • Ulcers
  • Gallstones
  • Liver disease
  • Intestinal problems
  • Heart attack

Diagnosis of Pancreatitis

Acute and chronic pancreatitis are diagnosed through a patient interview, medical exam, and several tests including blood, computerized tomography (CAT scan), ultrasound and Magnetic Resonance Imaging (MRI).

We may also use additional testing to rule out other conditions and further diagnose the cause of pancreatitis. One such option is the Endoscopic Retrograde Cholangiopancreatography (ERCP), a specialized x-ray of the bile ducts. This test enables us to diagnose problems in the liver, bile ducts, gallbladder, and pancreas, including pancreatitis.

Treatment of Pancreatitis

At Montefiore, we offer the full spectrum of treatment options for acute and chronic pancreatitis. For patients with severe acute pancreatitis patients are managed in the intensive care unit in collaboration with board certified specialist in intensive care, gastroenterology and surgery. An early and accurate diagnosis is critical in treating acute pancreatitis. Approximately 75 percent of patients with acute pancreatitis will improve within three to seven days with supportive therapy. Surgery is generally not required in acute pancreatitis unless to prevent future attacks or treat complications, while pain management, IV hydration, nutritional support are vital for a quick recovery.

Treatment for chronic pancreatitis is designed to reduce pain and to limit pancreatic duct obstruction in the hope of limiting destruction of the gland. Occasionally surgery may be used in patients with chronic pancreatitis to correct problems in the pancreas that cause pain.