We have listed some of the main pancreatic disorders that we treat at The Liver Centre in Perth. Our team of dedicated and experienced surgeons, specialist doctors and dietitians are here to help you understand and plan your treatment, and to aim for the best possible outcomes with excellent care and support. That’s because we believe you deserve expert surgery, genuine care and ongoing support as you prepare for treatment or during and after a surgical procedure.
Pancreatitis is a condition that results in pancreas inflammation. It can present as acute or chronic pancreatitis. Let’s start by explaining the role of the pancreas:
The pancreas is a specialised gland that lies behind the stomach in the upper abdomen and plays a very important role in:
- Food digestion and absorption - by secreting pancreatic juices to “digest” or “break down” ingested carbohydrates, fats and protein that we eat to allow absorption later on along the intestine.
- Metabolism and energy - making hormones that control your blood sugar levels (such as insulin and glucagon).
The two most common causes of pancreatitis are alcohol and gallstones and they account for 70-80% of all pancreatitis instances.
Other causes responsible for the remaining percentage include:
- Medical procedures (such as ERCP)
- Viral infections
- Trauma / accident
- High calcium in blood (hypercalcaemia)
- Overactive parathyroid gland (hyperparathyroidism)
- Unknown causes (idiopathic)
The pancreas produces digestive juices that help break down the components of the food that we eat: fats, proteins and carbohydrates. These juices are usually activated once they enter the bowel and mixed with the food. In general, pancreatitis occurs when these digestive juices gets activated “inappropriately” within the gland, causing injury to the pancreas itself and setting up an inflammatory process around the pancreas.
Acute pancreatitis manifests as severe pain in the middle of the abdomen and in your back. The inflammation is caused by damage from the digestive enzymes that the pancreas makes to its own surrounding tissues. Chronic pancreatitis is experienced as abdominal pain that occurs on a regular basis. If your pancreatitis is caused by gallstones, then in most cases the recommended treatment option is to remove your gallbladder.
At The Liver Centre in Perth, we are committed to deliver expert surgery and excellence in patient care. First, we focus on getting a comprehensive and clear diagnosis. Depending on the cause and nature of your pancreatic disorder, we then discuss the most suitable and most comfortable treatment for you. Because pancreatitis is a complicated condition, it can require weeks or even months of treatment. And because it can be such a life changing event, our team will be by your side to provide comfort and support throughout your treatment journey.
Also called “cystic lesions” or “cystic neoplasms of the pancreas”. They are a group of disorders where there is a collection of fluid within the pancreatic gland. Pancreatic cysts are more easily detected and identified nowadays since the advancements in radiology, particularly MRI.
The great majority of these lesions are benign and slow growing. In a small amount of cases the cells can transform and change into precancerous cells or cancer. If this is diagnosed in its early or precancerous stage, then there is a good chance for a surgical cure by removing the cysts. Examples of the types of cystic lesions that have a significant risk of becoming cancer include:
- Intraductal Papillary Mucinous Neoplasm (IPMN)
- Mucinous Cystic Neoplasm (MCN)
- Mucinous Cystadenoma
If you suffer from pancreatic cysts, our team of specialist doctors will assist you with planning the required tests. Then, a thorough diagnosis will allow us to organise your surgical treatment plan at the earliest convenience. We make sure that you fully understand every step of the process.
The tests are important because one of the challenges faced by a specialist surgeon is to determine what type of pancreatic cyst type it is. Sometimes further investigations may be required and they involve blood tests, a specialised radiology test such as MRI or minimally invasive procedures known as “EUS” (endoscopic ultrasound). The tests would need to be performed to obtain fluid samples from the cyst for analysis and to make a detailed diagnosis.
The pancreatic cysts mentioned above would need surgery to remove a part of the pancreas containing the cysts.
Benign pancreatic cysts do not pose any significant risk of turning into cancer and therefore no further treatment is needed. Examples of benign pancreatic cysts:
Sometimes, when the diagnosis is still unclear but the cyst is small and does not have any concerning features on a radiology test, a reasonable option would be to monitor it with specialised X-ray tests over regular time intervals. The purpose of monitoring it over time is to ensure that the cyst doesn’t grow or change.
We understand the pressure and stress that may come with a series of tests and the uncertainty that comes with them. That’s why you can count on our team to support you throughout the process, so we can organise the most effective and the most comfortable treatment for you at the earliest convenience.
Your team of experienced surgeons at The Liver Centre will always help you to fully understand your diagnosis and your condition, before discussing and planning the most effective and comfortable treatment with you. Our surgeons make use of their many years of experience in a broad variety of surgery types, and our team goes out of their way to support you with excellent care throughout your treatment journey.
What is pancreatic cancer?
The most common form of pancreatic cancer is known as pancreatic adenocarcinoma.
It affects the ducts, the small branching channels within the pancreatic glands that carry pancreatic juices into the small intestines.
There are other types of pancreatic cancer which are not as common, and they include:
- Neuroendocrine tumours
- Cystic neoplasms that have undergone a malignant transformation (see above e.g. MCN, IPMN)
In the early stages, pancreatic cancer could be asymptomatic. Depending on the size and location of the tumour along the pancreatic gland and/or whether the cancer has spread, the symptoms of pancreatic cancer could include:
- Unexplained loss of appetite and weight loss
- Jaundice (yellow discolouration to the whites of eyes, skin, accompanied by dark urine, pale stools or itchy skin)
- Abdominal pain
- Rarely, a new diagnosis of diabetes mellitus (high sugar level in blood).
The jaundice symptoms may indicate that the pancreatic tumour blocks the bile duct. In that case, your surgeon may want to take tissue samples from the bile duct with a “flexible camera procedure”. It’s called an ERCP: endoscopic retrograde cholangiopancreatography. During this procedure, a “stent” can be placed to relieve the blockage, which will also relieve the jaundice symptoms.
Pancreatic cancer is usually first diagnosed with information obtained from a CT scan. If you have been diagnosed, your surgeon and our whole team will make sure you understand the diagnosis. Then we will propose the most convenient and the most effective treatment plan, based on our many years of experience helping patients with pancreatic disorders.
An endoscopic ultrasound or EUS can be used to get a biopsy of the tumour. Other tests will be done routinely to help us collect information and to determine the stage of the tumour. This could include an MRI, and or PET scans. Occasionally, a laparoscopy (keyhole surgery) may be required to examine the internal organs to determine any signs of spread of the tumour.
As we plan your tests and treatments, you can also count on our team of health professionals to support you with genuine care and professionalism.
The treatment for pancreatic cancer will depend on several factors: your age, your medical fitness and the “stage” of the cancer.
When malignant cells are found in the pancreas, it may affect the function of your glands. Most pancreatic cancers are diagnosed in the head of the pancreas. Smoking, pancreatitis, genetic factors and diabetes are among the most common causes of pancreatic cancer, and the condition is the fifth most common cause of death, related to cancer.
The current and innovative treatment approach for pancreatic cancer involves a multidisciplinary team involving your surgeon, a medical oncologist, a radiation oncologist, nurses, dietitians, a gastroenterologist, and other allied health professionals here at The Liver Centre .
Because we believe you deserve excellence in surgical outcomes and in the quality of your care experience, your treatment plan will be highly individualised. It may involve a combination of chemotherapy, radiation therapy, endoscopy and surgery. As a team, we will go out of our way to help you organise your tests and treatments, and we commit to offering you support, kindness and care as you go through this process.
If you have been diagnosed with pancreatic cancer, it is essential to speak to one of our experienced specialist doctors here at The Liver Centre Perth at your earliest convenience. They build on many years of experience in theatre, and provide a personalised care and treatment plan for each individual patient.
A pancreatic neuroendocrine tumour (also called NET) forms in the islet cells of the pancreas. These cells have an important role in the body because they make hormones. A pancreatic NET may cause symptoms, or it may remain unnoticed until the tumour releases specific hormones and starts causing symptoms.
The different types of pancreatic NETs have different symptoms and our expert surgeons here at The Liver Centre will make use of their many years of experience to provide you with a comprehensive diagnosis.
If you need imaging tests or lab tests, our team will support you with clear communication, and plan your consultations or tests with minimal wait times in between. If surgery is required, our surgeons, dietitians and support team will be by your side to provide the highest possible level of care, comfort and support.
In mild cases of pancreatitis you may not be able to eat for a few days, but after it has settled you will be able to tolerate a low fat diet. Supplements may be required if you have a poor appetite or are losing weight. Pancreatitis can put huge energy demands on the body which can result in weight loss and it can affect your digestion. In some cases pancreatic enzyme tablets may be required, especially if your condition is chronic.
If you are losing weight because of pancreatic cancer, then your dietitian at The Liver Centre will assist you with a high protein diet. This is mainly to help you maintain your weight, and to prepare you for potential surgery or upcoming treatment like chemo or radiotherapy. Pancreatic enzymes may be required as the pancreas can lose some of its function. 10-20 % of patients also develop diabetes and may require insulin. It is important not to follow a restricted diet at this time as it can result in further unwanted weight loss. In this case it is often loss of muscle mass, causing additional weakness, so your dietitian will help you with a diet plan rich in protein to avoid that weight loss. With pancreatic neuroendocrine tumours, our dietitians will help you manage your symptoms pre or post treatment, to make sure that we improve and monitor your intake of nutrients.
At any stage of your treatment journey, our whole team of surgeons, dietitians and support staff will be available to you, to provide the right level of care. Whether it is diet, explaining symptoms or what to expect from your surgery, or mental support to give you courage and strength. As we work together for the best possible clinical outcome, we also go out of our way to make you feel as comfortable as possible.
If you have any questions about pancreatic disorders, please call The Liver Centre Perth today. We look forward to helping you.