Programs and Services
Diseases of the Pancreas and Treatments
Froedtert & The Medical College of Wisconsin physicians treat many diseases of the pancreas including:
Pancreatic TumorsSolid tumors of the pancreas
- Adenocarcinoma — an aggressive cancer that arises from the exocrine glands. (The exocrine glands produce pancreatic “juice,” which contains enzymes that digest fats, proteins and carbohydrates in food. More than 95 percent of the cells in the pancreas are exocrine glands and ducts). Adenocarcinomas usually begin in the ducts of the pancreas, and 85 percent to 90 percent of all cancerous tumors of the pancreas are this type of tumor.
- Neuroendocrine tumors — A hormone-producing tumor (islet cell tumor) in the pancreas. One of the most common types of neuroendocrine tumors is a carcinoid tumor.
Cystic tumors of the pancreas
Many types of cysts can be found in the pancreas. Cysts can be benign, pre-malignant or malignant. Treatment depends upon the type of cyst. Cysts are often found during a CT scan or MRI scan done for other purposes.
- Serous cystic neoplasm (SCN) — a spongy, localized cyst in the pancreas that is usually benign. These cysts may be located anywhere in the pancreas. They may be removed surgically if they cause symptoms or if a diagnosis cannot be firmly defined by standard imaging and biopsies/fine needle aspiration.
- Mucinous cystic neoplasm (MCN) — 30 percent of cysts in the pancreas are this type, which ranges from benign to malignant. It is made up of cells that produce mucin, a component of mucus. About 70 percent to 90 percent of these cysts are found in the body or tail of the pancreas, and one-third are associated with invasive cancer of the pancreas.
- Intraductal papillary mucinous neoplasms (IPMN) — cysts consisting of mucin-producing tumors. They involve the main pancreatic duct or major side branches. These cysts are usually found in the head and neck of the pancreas or uncinate process of the pancreas (part of the head of the pancreas). IPMNs have a high potential for progressing from benign growths to invasive cancer.
Pancreatic Pseudocysts A pseudocyst is a localized fluid collection of pancreatic enzymes that often appears several weeks after the onset of pancreatitis.
Pancreatitis Pancreatitis is an acute or chronic inflammation of the pancreas that may be caused by heavy alcohol use or gallstones (the two primary causes) or by certain medical conditions, some drugs or an unknown cause.
Treatments/Interventions for Diseases of the PancreasFroedtert & The Medical College surgeons perform a variety of procedures on the pancreas to treat disease caused by tumors (benign or malignant) and by inflammation (acute or chronic).
Surgery to Remove TumorsThe best chance for cure of pancreatic cancer is an early diagnosis and surgical removal of the cancer. Some patients with pancreatic cancer are candidates for surgery. All or part of the pancreas may be removed, depending on the location and size of the tumor, the stage of the disease and the patient’s overall health. (If the cancer has spread beyond the pancreas, surgical removal will not cure this type of cancer.)
- Pancreaticoduodenectomy (also called the Whipple procedure) — surgery to remove a tumor in the head of the pancreas. The procedure involves removing the head of the pancreas, the duodenum (first part of the small intestine), gallbladder, part of the common bile duct and lymph nodes near the pancreas. Froedtert & The Medical College have performed many of these procedures and many patients from throughout the region are referred here for this surgery.
- Pancreatectomy — surgical removal of all or part of the pancreas. In a total pancreatectomy, the entire pancreas is removed, usually along with the spleen, gallbladder, common bile duct and portions of the small intestine and stomach. In a distal pancreatectomy, only the body and tail of the pancreas are removed, leaving the head of the pancreas. After a total pancreatectomy, the body loses the ability to secrete insulin, enzymes and other substances. These conditions are treated with pancreatic enzyme replacement therapy, which supplies digestive enzymes, and with insulin injections.
- Ampullectomy — removal of tumors of the ampulla of Vater (the junction of the ducts from the liver and pancreas at the point where they enter the small intestine)
- Enucleation — removal of just the tumor in the pancreas without removing surrounding pancreas.
Other Pancreatic Surgery
- Pancreaticojejunostomy (Puestow procedure) — drainage of the pancreatic duct into the small intestine to relieve the pain of chronic pancreatitis due to obstruction of the duct
Author: Marla Fraunfelder
|Medical Reviewer: ||Kathleen Christians, MD, FACS|
|Edward Quebbeman, MD, PhD|
Last Review Date: April 25, 2007
Online Editor(s): Christopher Sadler