Specialists call the pancreas a very delicate and unpredictable organ. This is explained by the fact that it is not clear how she will behave in a given situation during surgical treatment. This is usually done with pancreatitis or with acute organ injury.
The operation on the pancreas is considered one of the most difficult. Differs from others in a large number of deaths.
Prognosis generally depends on the stage of the disease and the general condition of the body, the age of the person. After pancreatic surgery, it takes a long time for the patient to recover and recover.
When is surgery needed?
This organ causes a lot of trouble for specialists both during and after surgery. When removing the pancreas, the operation should be performed only by qualified doctors and only when strictly necessary.
Data for surgical treatment may be the followingdiseases:
- organ injury;
- frequent exacerbations of chronic pancreatitis;
- malignant neoplasm;
- pancreatic necrosis;
- acute destructive pancreatitis;
- pseudocysts and chronic cysts.
What are the difficulties in surgery?
The operation to remove the pancreas causes some difficulties, which are associated both with its physiology and with the location and structure of the organ. It is located in an "uncomfortable place". In addition, it has a joint blood circulation with the duodenum.
The pancreas is close to organs such as the kidneys and abdominal aorta, the common bile duct, and the inferior and superior vena cava.
Also, the difficulties of surgery for acute pancreatitis are associated with the enzymatic function of the gland. This is explained by the fact that the latter can digest the tissues of the organ itself.
In addition, surgery is fraught with consequences such as the formation of fistulas and bleeding. This can happen due to the fact that the parenchymal tissue that makes up the organ is very fragile. Therefore, it is very difficult to suture her.
How does surgery work?
An operation is also required for pancreatic cancer. Other cases requiring surgical treatment were listed above. Also, with a pancreatic cyst, surgery is a mandatory procedure. Surgical treatment is performed under the influence of general anesthesia andmuscle relaxants.
If there are symptoms of internal bleeding, then an emergency operation on this organ is required. In other cases, a planned surgical intervention is performed.
So, pancreatic surgery is performed as follows:
- first, the organ is opened;
- stuffing bag free from blood;
- superficial ruptures of the pancreas are sutured;
- hematomas are opened and bandaged;
- if there is a rupture of the organ, sutures are placed on it, and at this time the pancreatic duct is sutured;
- if the main disorders are in the tail of the pancreas, then this part is removed together with the spleen;
- if the head of the organ is damaged, it is also removed, but with part of the duodenum;
- surgery ends with drainage of the omental sac.
Some types of surgical treatment
In the presence of a pancreatic cyst, the operation involves the removal of the first part of the organ. As a rule, in this situation, surgery is not considered one of the most difficult.
With stones in the pancreas, the operation begins with a dissection of the tissue of the organ. The walls of the duct are also exposed to this influence. After that, the stones are removed. If there are a large number of the latter, then a longitudinal dissection of the organ is performed, followed by removal of stones.
Sometimes people get diagnosed with cancerpancreas. The operation is the most difficult. With a tumor of the tail and body, the gland and spleen are removed. In case of a malignant neoplasm in the tail and head, the organ is removed along with the duodenum and spleen.
Pancreas resection - what is it?
This organ is partially removed, but not completely, because a person cannot live without it. This method of treatment is called resection. As a rule, they resort to it with a malignant tumor.
In order to remove the head of the organ, Frey's operation is performed. It is very dangerous and difficult.
Surgical intervention with this method is performed with pancreatic necrosis, trauma in which most of the pancreas is damaged, and with a tumor.
Prognosis after surgery is mixed. Of course, missing organ parts are not restored.
When removing the tail of the pancreas, a favorable outcome is quite possible without digestive disorders and the development of diabetes mellitus. But with additional surgery on the spleen, there is a high risk of a decrease in immunity and the formation of thrombosis.
After Frey's operation, consequences such as infectious complications, bleeding, damage to nearby nerves and blood vessels are possible.
After surgery, a person has a lack of hormones and enzymes. After all, they were produced by a remote organ. In this case, the patient is prescribed substitution treatment, which allows you to slightly replace the function of the gland.
Pancreas transplant
Thisthe operation is very difficult. It is not carried out, even if the patient is diagnosed with a tumor of the gland. The latter is very rarely removed. Firstly, the operation is considered very expensive, and secondly, a small percentage of patient survival. Since the pancreas is an unpaired organ, it can only be taken from an inanimate person.
After freezing, the organ can only be stored for about four hours. This is the complexity of the surgical intervention for pancreas transplantation.
Placing a donor organ in its physiological place is difficult. Its transplantation is carried out by moving it into the abdominal cavity and connecting it with the iliac, splenic, hepatic vessels.
It is very problematic to do this, and there is a high probability of death of the patient due to shock and severe bleeding. Therefore, this method of surgical intervention is not practiced.
Tissues of the pancreas are characterized by high antigenicity. And if there is no appropriate therapy, the donor gland will remain only a few days after surgical treatment. Then rejection will occur.
What are the postoperative complications?
As a rule, one of the most common consequences after surgery is postoperative pancreatitis. Symptoms of the development of this disease will be:
- leukocytosis;
- increased body temperature;
- rapid deterioration of human condition;
- severe pain in the epigastric region;
- high blood and urine amylase levels.
Acute pancreatitis most often occurs in patients who develop an acute obstruction of the main duct after pancreatic surgery. This happens due to edema of the organ.
Other complications after surgery include exacerbation of diabetes mellitus, peritonitis and bleeding, circulatory failure, pancreatic necrosis and renal liver failure.
What is postoperative care?
Appropriate therapy is prescribed by a specialist after reviewing the patient's medical history.
As a rule, after the operation, doctors advise to stick to a diet, observe a special sparing regimen, eat special enzyme supplements that help digest food.
It is also a prerequisite for physical therapy and physiotherapy.
Because most people develop diabetes after having their pancreas removed, they are prescribed insulin.
Diet after surgery
Therapeutic nutrition is one of the main components of the patient's rehabilitation period.
The diet starts after two days of fasting. On the third day, the patient is allowed to eat pureed soups, sugar-free teas, crackers, rice and buckwheat milk porridge, cottage cheese, a little butter and a steamed protein omelet.
Before going to bed, the patient can drink a glass of water with honey or yogurt.
The first seven days for the patient, all food shouldget ready for a couple. After this period, you can eat boiled foods.
Prognosis after surgery
Usually, what will be the fate of a person depends on the preoperative condition of the patient, the method of surgical treatment, the quality of dispensary activities and proper nutrition.
The pathological condition, due to which part of the pancreas was removed, continues to affect the condition of the patient.
When an organ is resected for cancer, there is a high probability of recurrence. If any adverse symptoms appear in such patients, a specialist should be consulted in order to exclude the process of metastasis.
Physical and mental strain, violation of therapeutic procedures and proper nutrition may not have a very good effect on the patient's body. It also leads to the development of exacerbations of pancreatic diseases. The correctness, discipline and strict observance of all the surgeon's appointments determine how long and how a person will live.
Pancreas surgery: patient reviews
Having studied the cases of surgical treatment, we can say that the responses are quite positive. Basically, we are talking about malignant neoplasms in the pancreas. Relatives and the patients themselves say that they managed to defeat the disease, despite fears.
Thus, surgical intervention, thanks to the help of qualified specialists, is a kind oflifeline for patients.
There are also reviews of people about pancreatic necrosis. As you know, this disease is a neglected case of acute pancreatitis. A large number of thanks to the surgeons from the people who helped them survive can be seen on the Internet.
It follows that, despite the fact that pancreatic surgery is considered one of the most difficult surgical types of treatment, it helps patients to get out and continue to work in the same spirit. Just do not forget a number of recommendations and advice given by the doctor. And then you will feel he althy and complete.
