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pancreas

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  • The pancreas is a solid retroperitoneal organ situated located behind the stomach with in the 'C' loop of duodenum

  • It has head, neck, uncinate process, body & tail

  • The main pancreatic duct (MPD) joins the CBD & enters the 2nd part of duodenum

  • The pancreas has both endocrine and exocrine function

    • As an endocrine gland, it secretes hormones like insulin, glucagon, somatostatin, and pancreatic polypeptide  

    • Its main function is to regulate blood sugar levels

    • As a part of the digestive system, it also functions as an exocrine gland secreting pancreatic juice into the duodenum through the pancreatic duct. This juice contains bicarbonate, which neutralizes acid entering the duodenum from the stomach

    • It secrets digestive enzymes, namely amylase & lipase which helps digestion and absorption carbohydrates, proteins, and fats

  • Because of its role in the regulation of blood sugar, pancreas is a key organ in onset of diabetes mellitus (Type 1& 2)

    • So, any pancreatic disorder or surgery may result in onset of diabetes. For examples- Chronic pancreatitis, surgery like pancreatectomy, where there will be significant loss of endocrine and exocrine function.

What are the common pancreatic disorders?

  • Pancreatitis

    • Acute Pancreatitis

    • Acute necrotizing pancreatitis

    • Chronic pancreatitis

  • Pseudocyst of pancreas

  • Tumors

    • Cystic tumors

      • Serous cystadenoma, Mucinous cystadenoma, IPMN etc.

    • Malignant

      • Pancreatic cancer (adenocarcinoma)

      • Neuro-endocrine tumors- insulinoma, glucagonoma etc.

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What are the common symptoms of Pancreatic disorders?

  • Pain in upper abdomen

  • Lump in upper abdomen

  • Fever

  • Jaundice

  • Vomiting 

  • Steatorrhea ( Bulky, fatty stool) etc.

  • New onset diabetes mellitus

What are the commonly done tests for pancreatic disorders?

  • Blood tests- Serum amylase, Serum Lipase

  • Tumor markers- CA-19.9

  • Imaging - Ultrasonography, CT, MRI, EUS, PET scan etc. 

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What are the commonly done pancreatic procedures/surgeries?

  • For chronic pancreatitis

    • Drainage procedures - LPJ (Lateral pancreatico jejunostomy), Frey's procedure etc.

  • Necrosectomy for necrotizing pancreatitis

  • Surgery for pancreatic tumors

    • Whipple's procedure

    • Distal Pancreatectomy +/- splenectomy

    • Enucleation etc.

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