Pancreas anatomy and its function
The pancreas is a small digestive organ located behind the stomach. It measures about 15-20 cm in length and 2-3 cm in width, and weighs about 80-120 grams. Despite its small size, it plays an important role in digestion by secreting digestive juices and hormones such as insulin. A decreased function of the pancreas can cause digestive problems due to reduced secretion of digestive juices and lead to diabetes due to insulin deficiency.
Pancreatitis is a disease in which there is some problem in the pancreas that leads to pancreatic dysfunction. It is mainly divided into acute pancreatitis and chronic pancreatitis.
Acute Pancreatitis is a disease in which inflammation suddenly occurs in the pancreas due to factors such as alcohol, gallstones, and hyperlipidemia. The pancreas secretes digestive juices, and if the pancreatitis has occurred, pancreas can digest itself with its own digestive juices, and in the worst case, it can cause multiple organ failure and become fatal. If alcohol is the cause, conservative treatment is performed and if gallstones are the cause, bile duct stones are primarily removed by endoscopy. In severe cases, admission to the ICU may be necessary.
If someone who drinks a lot of alcohol or eats a lot of fatty foods, suddenly experiences abdominal pain, or if someone with hyperlipidemia or gallstones experiences sudden abdominal pain, acute pancreatitis is suspected. Acute pancreatitis is diagnosed by blood tests and imaging tests, and almost all cases require hospitalization for treatment once diagnosed.
When acute pancreatitis occurs, the serum amylase enzyme increases. Our clinic can perform a serum amylase test within 10 minutes.
Chronic pancreatitis is a disease in which the pancreas is degraded (fibrosis) mainly by alcohol and its function decreases. Rarely, some people develop chronic pancreatitis due to autoimmunity. Symptoms include abdominal pain, back pain, weight loss, diarrhea, etc. As the condition progresses and pancreatic function decreases, conscious symptoms become less, but malnutrition due to decreased pancreatic function is seen, and even with weight loss, the onset of diabetes due to decreased insulin secretion is recognized. The disease is diagnosed by blood tests and imaging examinations. In cases of autoimmune origin, it is often said that the value of IgG-4 in the blood is high. As a treatment, there is no fundamental cure for those caused by alcohol, mainly symptomatic treatment with drugs is performed. In cases of autoimmune origin, treatment with steroid drugs is performed. If symptoms worsen, hospitalization may be necessary, and endoscopic treatment to improve the flow of the pancreatic duct or surgical therapy may be performed. In the case of alcohol-related chronic pancreatitis, insulin therapy may be necessary for diabetes. In the case of alcohol-related chronic pancreatitis, it is common for those with alcohol dependence to be affected, and in addition to the treatment of the pancreas, an approach to alcohol dependence is also necessary.
A pancreatic cyst is a sac filled with fluid that forms in the pancreas. There are various causes of pancreatic cysts, which can be divided into tumors or inflammatory ones. Inflammatory cysts often appear as a complication after acute pancreatitis. Tumor cysts are often benign and asymptomatic, so they are usually monitored, but some can become malignant over time. If malignancy is suspected, surgery may be necessary, so it is important to undergo regular precise examinations if a pancreatic cyst is diagnosed. Some pancreatic cysts, such as Intraductal Papillary Mucinous Neoplasms (IPMNs), could have a high potential to develop into pancreatic cancer even if they are benign initially. Regular precise examinations are also necessary for these types of cysts.
Pancreatic cancer is a highly aggressive form of cancer that is difficult to detect in its early stages. In Japan, approximately 34,000 people die from pancreatic cancer each year, making it the fourth leading cause of cancer death. There are various factors that contribute to its development, including smoking, obesity, diabetes, chronic pancreatitis, and genetics, although the direct cause is unknown. Recently, intraductal papillary mucinous neoplasm (IPMN) has been identified as a risk factor for pancreatic cancer. If there are three or more cases of pancreatic cancer in a family, the likelihood of developing pancreatic cancer increases 32 times.
Diagnosis of pancreatic cancer is made through blood tests, imaging tests, endoscopic tests, and pathological tests. Unfortunately, symptoms such as abdominal pain and discomfort are common and non-specific, making early detection difficult.
If pancreatic cancer is suspected from symptons, the diagnosis is made through ultrasound, CT scans with contrast agents, and MRI (MRCP) scans. However, these tests alone are not enough to diagnose early-stage pancreatic cancer. If pancreatic cancer is strongly suspected, further testing, such as endoscopic examination to collect pancreatic cells, will be performed (usually while the patient is hospitalized). If the cell test results are diagnosed as malignant, it is considered a definitive diagnosis of pancreatic cancer.
Treatment options include surgical therapy, radiation therapy, and chemotherapy (anti-cancer drugs). Only about one-third of pancreatic cancers can be removed through surgery, and the remaining two-thirds are already inoperable at the time of diagnosis. The earliest stage (Stage 0) has a surgical success rate of 85.8%, but the success rate decreases as the stage advances. Chemotherapy and radiation therapy can be used to relieve symptoms and improve quality of life, but the prognosis for pancreatic cancer is generally poor.