Pancréatectomie

In medicine, a pancreatectomy is the surgical removal of all or part of the pancreas. Several types of pancreatectomy exist, including pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy. In recent years, the TP-IAT (Total Pancreatectomy with Islet Autotransplantation) has also gained respectable traction within the medical community. These procedures are used in the management of several conditions involving the pancreas, such as benign pancreatic tumors, pancreatic cancer, and pancreatitis. It is performed for a variety of reasons, including: Inflammation Necrotising pancreatitis Chronic pancreatitis with pain Trauma Neoplasms Adenocarcinoma (85%) Cystadenoma (mucinous/serous) Cystadenocarcinoma Islet cell tumors (neuroendocrine tumors) Papillary cystic neoplasms Lymphoma Acinar cell tumors Severe hyperinsulinemic hypoglycemia The most common surgical procedure involving removal of a portion of the pancreas is called a pancreaticoduodenectomy. Among common consequences of complete or nearly complete pancreatectomy are deficiencies of pancreatic endocrine or exocrine function requiring replacement of insulin or digestive enzymes. The patient immediately develops type 1 diabetes, with little hope for future type 1 diabetes treatments involving the restoration of endocrine function to a damaged pancreas, since the pancreas is either partially or completely absent. Type 1 diabetes can be treated with careful blood glucose monitoring and insulin therapy. Because the pancreas is responsible for the production of many digestive enzymes, a pancreatectomy should only be given as an option for pancreatic disease which is life-threatening, such as pancreatic cancers. It is very important to note that even after a pancreatectomy, pain still exists in most patients. A distal pancreatectomy is removal of the body and tail of the pancreas. After a total pancreatectomy, the body no longer produces its own insulin or pancreatic enzymes, so patients have to take insulin and enzyme supplements.