1 Medical indications

For pancreatic pathologies, surgery is indicated for tumors of both malignant and benign, with cystic lesions, as well as inflammatory processes and parasitic diseases. Pancreas surgery is indicated in chronic pancreatitis, when the pain syndrome is very severe, with trauma with bleeding, abscesses. If there is internal bleeding, the operation is carried out in an emergency. All other surgical interventions are planned.

The course of the operation depends on the process that led to the need for it,but, for example, with internal bleeding, it looks something like this:

• the patient is undergoing general anesthesia;
• pancreas is revealed;The
• stuffing box is freed from blood;
• graft ruptures are sutured;
• hematomas are bandaged;
• if there is a gap, then sutures are applied, the pancreatic duct also stitches;
• if necessary, the tail of the gland and spleen is removed;
• if the lesions are in the head of the organ, then it is removed from the site of the 12-duodenum;
• at the end of the operation, the gland bag is drained.

In some cases, laparoscopic intervention is permitted.

With regard to the removal of stones from the pancreas, in this case, the duct is cut over the calculus and its extraction is performed. If there are several stones, a longitudinal incision is made.

The cyst is removed along with the tissue or even part of the pancreas itself. In the case of oncology, a resection of the organ and spleen is performed. If the tumor is localized on the head and tail, then resection of the spleen and 12 duodenal ulcer is performed.

2 Resection of the gland

Resection is the excision of part of the organ. In the case of the pancreas, it is used in pancreatitis, this manipulation is very rare. At a pancreas it is possible to remove only one of parts - or a head with 12 duodenum, or a body and a tail of the gland itself.

After the resection of the damaged organ and tissues, it is very important to form out of the remainder of the gland the outflow of bile and secretion. Surgeons collect it as follows:

• create a common duct with gut;
• duct of the gland and intestinal loops;
• conduct the duct from the outlet of the stomach with the small intestine;
• sometimes the duct is made into the stomach, and not into the intestine.

If the examination reveals that the tumor is very large, then it is possible to remove the entire body as a whole, this process is called total pancreatectomy.

3 Possible difficulties

In connection with the anatomical structure of the organ and its physiology, surgical intervention may have some difficulties. The fact is that the gland and the duodenum have a common blood circulation, besides the location of the pancreas is quite inconvenient for the operation. It is located very close to the abdominal aorta, kidneys, bile duct, mesenteric vein, upper artery, upper and lower hollow veins.

In addition, the operation hampers the enzymatic functions of the organ, often pancreatic enzymes are so active that they begin to digest the tissues of the gland itself. On the parenchymal tissue it is quite problematic to impose seams, therefore complications in the form of bleeding and fistula may occur in the post-operation period.

4 Preoperative and postoperative periods

Pancreas surgery, like other cavity interventions, requires pre-treatment of the patient. However, to a greater extent, surgery on the pancreas is performed at special indications, that is, when the risk of not performing an operation exceeds the risk of the intervention itself and its consequences. Contraindication can only be extremely difficult condition of the patient.

After the operation for several days, the patient is fed by means of droppers. There may be another option - during the operation on the pancreas a probe is inserted, through which nutrient mixtures enter immediately into the intestine. Then the patient will be allowed to drink a slightly brewed unsweetened tea and eat a dried piece of white bread.

A little later it is allowed to eat mashed unsalted or slightly salted soups, omelette, steamed, and crackers. Then the ration includes porridge - rice and buckwheat, then you can introduce meat or fish cooked in a steam way. On the tenth day of the operation you can eat everything except smoked, fried and fatty.

Consequences following surgical intervention may be as follows:

• bleeding;
• diabetes;
• inefficient patency of the ducts;
• problems with digestion and absorption of nutrients;
• complications of an inflammatory nature.

Negative consequences of surgical intervention can be manifested in the defeat of nerves and large vessels that are located close to the pancreas, and the consequences may be associated with a lack of enzyme production.

5 How to live after?

The diet after surgery on the pancreas is completely stipulated by the attending physician at discharge. As a rule, it must be observed by the patient until the end of life. Take food is recommended fractional 5-6 times a day in small portions. The fat content should be minimal. Alcohol should be absolutely excluded. The doctor will prescribe the enzymes - preparations in the enteric membrane.

It is necessary to monitor the level of sugar in the blood. When resection of the pancreas, the development of diabetes mellitus does not always occur, it occurs in about half the cases. But if diabetes is diagnosed, then insulin therapy is indicated according to the scheme that the endocrinologist will appoint.

In the first few months after surgery, the patient may lose weight, after eating, discomfort and pain may be felt. Often there is a loose and frequent stool, there may be weakness, beriberi. But, as a rule, these are temporary symptoms, so the body adapts to new conditions, after a while self-regulation will take place, and life will enter the usual rut.

6 Forecast

In most cases, the prognosis depends on how the patient felt before the intervention, how correctly he eats after surgery and how much the patient wants to live a normal life. With oncology, after resection of the pancreas, relapses may occur, a 5-year survival rate of only 10%.

Patient failure in diet, treatment and physical overexertion can lead to adverse effects. There can be an exacerbation, and severe consequences of pancreatic diseases will appear. Therefore it is very important that the patient competently and disciplined approach to all medical recommendations, because on that depends the usefulness of the further life.