Pancreatic cancer is a tough and severe cancer prognosis. Of all the major cancers, pancreatic has one of the worst survival durations. The survival length of untreated advanced-stage pancreatic cancer is around 3.5 months.  Early diagnosis and treatment are critical for effective treatment. One of the most complex surgical procedures performed, hepato-pancreato-biliary surgery, is the best chance to cure the condition.

Learn more about pancreatic cancer and treatment from The Surgical Clinic in Tennessee below.

 

HPB Surgery for Pancreatic Cancer

More commonly referred to as HPB, hepato-pancreato-biliary surgery encompasses various procedures that treat conditions in the liver, bile system, and pancreas.

 

Complex Issues – Role of the Pancreas

Together, the liver, gallbladder, pancreas, and duodenum form an important subsystem within the digestive system. Enzymes, bile, and bile salts produced and stored in the gallbladder inject into this tract during digestion. The pancreas also produces enzymes and adds them to the intestinal tract for digestion.

Collectively, these naturally produced enzymes, biles, and salts break down food into manageable nutrients for the body to store or use.

These organs are essential for the effective digestion of food. As a result, diet plays an integral part in maintaining this complex and interconnected system within the body.

There are also other vital structures and major blood vessels through the abdomen on top of these essential organs. Altogether, these systems make operating in the abdomen complex and challenging.

 

Complex Treatment – Pancreatic Cancer Survival

It takes the teamwork of physicians and surgeons to treat the conditions of pancreatic cancer. If you need full HPB care, you won’t be working with just one surgeon or one provider. Needing a team is especially true for cancer patients. We take a team approach to treatment to determine the best path for treatment accurately.

For example, an HPB treatment team would include your primary care provider, a general surgeon, and a surgical oncologist. You may also meet with a nutritionist, a radiology specialist, or a pathologist.

 

When you work with a team of HPB specialists, you will play an active role in shaping your treatment. It will be up to you whether you undergo surgery or only want a recommendation for treatment.

Types of HPB Conditions

HPB surgery covers a wide range of conditions that affect the liver, pancreas, and bile system. Surgeons who specialize in this field, therefore, treat a wide array of conditions that can be either malignant or benign.

 

Malignant Hepato-pancreato-biliary Conditions

Hepatobiliary Cancer

Generally speaking, hepatobiliary cancer includes any cancer that originates in the liver, gallbladder, or bile ducts. The difficulty of diagnosing liver cancers is, in part, due to the vagueness of symptoms and confusion with symptoms of other conditions. Some signs of liver cancer include abdominal pain, weight loss, weakness, and jaundice.

 

Pancreas Cancers

The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma (PDAC). The cancer cells begin developing in the lining of the pancreatic duct before it spreads to other areas of the body. Typically, this cancer spreads before it is detected. PDAC is aggressive and often lethal. Therefore, it’s essential to ask your doctor about your risk factors for pancreatic cancer. Symptoms often won’t occur until the cancer is in advanced stages. Abdominal pain, loss of appetite, light stool, dark urine, blood clots, and fatigue are all possible signs of pancreas cancer.

Hepato-Pancreato-Biliary Surgery & Pancreas Cancer The Surgical Clinic in Tennessee

 

Islet Cell Tumors

Pancreas cells cluster together in groups. When a cancer tumor occurs in these small cell groups, it is called an islet cell tumor. These tumors can be either benign or malignant. Also called pancreatic neuroendocrine tumors, islet cell tumors are rare and grow slowly. As a result, symptoms can be hard to detect until later stages. But, like other hepatobiliary cancers, symptoms can include abdominal pain, jaundice, and back pain.

 

Benign Hepato-pancreato-biliary Conditions

The following conditions are non-cancerous diseases that occur anywhere within the liver, pancreas, gall bladder, or bile ducts. Some of these conditions require treatment by only one general surgeon. Others may need the attention of a team of specialists.

 

Chronic Pancreatitis

This condition occurs when the pancreas becomes and stays inflamed. Over time, constant inflammation damages the pancreas’ structure and ability to function. As a result, patients with chronic pancreatitis have a higher risk of diabetes due to inhibited insulin production.

 

Symptoms of chronic pancreatitis include abdominal pain, back pain, and diabetes. If your health history includes smoking or alcohol abuse, you have a higher risk of developing chronic pancreatitis. Additionally, people who have a family history of chronic pancreatitis have a higher risk, as well.

 

Gall Stones

The gallbladder is a small organ located just below your liver. Its primary function is to store and release bile into the digestive tract to aid in digestion. However, over time, high levels of cholesterol in bile can form stones.

These conditions, especially liver and pancreatic cancer, can be hard to identify in their early stages. Diagnosing and treating these conditions is difficult for this reason.

 

Other Notable Conditions Related to Pancreatic Cancer

Cirrhosis

When the liver is damaged, it repairs itself. This damage can happen from consuming large amounts of alcohol or from diseases like hepatitis. Over time, the rehealing of these injuries can create scarring, known as fibrosis. Cirrhosis raises the risk of developing pancreatic cancer.

 

What Surgeries are Performed in HPB Surgery?

To remove pancreatic cancers, these are some of the most common surgical procedures performed.

 

Whipple Procedure

Whipple procedure is a complex surgical treatment for pancreatic cancer that is often lifesaving. The pancreas head is surgically removed along with the gallbladder, bile duct, and a portion of the small intestine. With the tumors removed, the organs are surgically reattached to allow normal digestion.

 

Distal Pancreatectomy

During a distal pancreatectomy surgery, the body and tail of the pancreas are surgically removed.  If the cancer has spread, the spleen may also be removed. As the spleen is beneath the rib cage, enlarged tumors are often not felt. The spleen filters blood and helps with immunity.

 

Total Pancreatectomy

A total pancreatectomy is a complicated surgical procedure to treat pancreas cancer. As the name suggests, the entire pancreas is removed. Often times, the spleen, gallbladder, bile duct, and partial intestine are also removed.

Without the pancreas, the body can’t create insulin. Combining this procedure with an islet cell transplant is necessary to prevent diabetes.

 

If you suspect you are developing pancreatic cancer, scheduling a screening is imperative. The board certified surgeons at The Surgical Clinic can administer the correct tests to diagnose pancreatic cancer. Treatment will depend on the stage of the disease and the tissues affected. This same surgical team will work together to treat or control the cancerous cells. Give The Surgical Clinic a call at the location nearest you.

 

Research links:

Liver, Pancreas and Biliary Surgery. (n.d.). Atrium Health.
https://atriumhealth.org/medical-services/specialty-care/surgery/liver-pancreas-treatment

Hepato-Pancreato-Biliary (HPB) Surgery | Department of Surgery | University of Pittsburgh. (n.d.). University of Pittsburgh. http://www.surgery.pitt.edu/divisions/hepato-pancreato-biliary-hpb-surgery

About types of Hepatico-pancreatico-biliary (HPB) conditions. (n.d.). University Hospitals Plymouth NHS Trust.
https://www.plymouthhospitals.nhs.uk/liver-hpb-conditions#:%7E:text=Liver%20and%20HPB%20Conditions,-Hepatico%2Dpancreatico%2Dbiliary&text=The%20clinicians%20at%20the%20Plymouth,liver%2C%20pancreas%20and%20biliary%20system.&text=Secondary%20liver%20cancer%20(Metastatic%20cancer,has%20spread%20to%20the%20liver.

Merck Manuals. (2019, October). Gallbladder and Biliary Tract. Merck Manuals Consumer Version.
https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/biology-of-the-liver-and-gallbladder/gallbladder-and-biliary-tract

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