What is the Pancreas ?

The pancreas is a solid organ located deep in the abdomen that produces digestive enzymes to assist with digestion of food. These enzymes enter the small intestine through a pancreatic duct, which drains into the duodenum, (the first part of the small intestine). The pancreas also produces hormones which are secreted directly into the bloodstream through small blood vessels. Some of these hormones include insulin, glucagon, gastrin, and vasoactive intestinal peptide (VIP).

Hormones are secreted by a group of cells called "islet cells" since they are clustered together like islands. Approximately 5% of the mass of the pancreas is composed of islets Occasionally these islet cells form tumors known as neuroendocrine tumors. These tumors may or may not secrete measurable amounts of pancreatic hormones.

When is Pancreatic Surgery Necessary ?

When the pancreas forms tumors (neuroendocrine or adenocarcinoma) which may or may not secrete hormones, removal of the tumor and adjacent parts of the pancreas may be necessary. If a tumor of islet cells occurs, it may overproduce one or more of these hormones. These tumors are often named by their hormone plus the suffix "oma." Therefore, an insulinoma overproduces insulin and will cause low blood sugar (hypoglycemia). A glucagonoma overproduces glucagon and will cause high blood sugar (diabetes) and characteristic skin changes.  A gastrinoma secretes gastrin and may cause excess stomach acid secretion, ulcers, and diarrhea. A VIPoma is a very rare tumor which secretes vasoactive intestinal peptide and causes a high-volume watery diarrhea with electrolyte imbalances.

How is Pancreatic Surgery Performed ?

Operations on the pancreas typically require an abdominal incision with dissection of the stomach and intestines to expose the pancreas located deep within the abdomen. Some endocrine tumors may be    dissected out of the substance of the pancreas, but in some cases may require partial removal of the pancreas (pancreatectomy).