What functions are performed by the pancreas?

The pancreas perorms two essential functions:

1) Digestion: The pancreas produces digestive enzymes (proteins) which assist in the digestion of carbohydrates (amylase), fats (lipase), and protein (protease). The pancreas releases these digestive enzymes into the duodenum in the form of a clear, transparent liquid, known as pancreatic fluid. To neutralise acidic stomach fluids, bicarbonate is also produced in the pancreas. Hormones regulate the composition of pancreatic fluid according to fatty and acidic food content. Quantity is also regulated by the intake of food and approx. 1500 to 3000ml are produced each day. The liquid has excellent digestive qualities. The amount of this fluid produced is controlled by the food which is eaten and lies between 500 and 3000 ml per day. The fluid is highly effective as a digestive agent and therefore dangerous if it escapes from the intestines, because it digests everything! As a result, in the case of acute pancreatitis, and following operations on the pancreas, there is a risk that the fluid will seep into the bloodstream or into the abdominal cavity with disastrous results: the body begins to eat itself!

2) Endocrine Functions: The pancreas also contains a second, quite different organ, the main purpose of which is to produce insulin, a hormone which is vital to the sugar and carbohydrate metabolism. Insulin does not flow into the intestines in the fluid, but reaches all the organs via the bloodstream (liver, brain, heart), and there converts sugar into an energy source for the cells. If the pancreas fails the produce enough insulin or any insulin at all, this causes diabetes, and this must be treated with an insulin therapy. In addition to insulin, the pancreas produces a host of other enzymes, such as glucagon, somatostatin and pancreatic polypeptide. All these hormones play a role in the metabolism, but they are less important than insulin.

How do I know that I have a problem with my pancreas?
Normally, patients experience abdominal pain which radiates round to the back (the pancreas lies to the rear of the abdomen, which explains the back pain). The onset of the pain can be quite sudden and severe (acute pancreatitis), recurrent (chronic pancreatitis), or it can increase slowly over a longer period (pancreatic tumours). Other symptoms of pancreatic disorders include diarrhoea (problems with digestion) or diabetes (insulin deficiency).

What are the most common symptoms?
Pain in the upper abdomen and in the middle of the abdomen which radiates to the flanks and round to the back, like a belt.

What should I do if I think there is something wrong with my pancreas?
Contact your family physician immediately and describe the symptoms to him: he will then test the blood for pancreatic enzymes and arrange an ultrasound examination of the abdomen.

What is a pancreatic carcinoma?
A pancreatic carcinoma is a form of cancer affecting the pancreas. It is a very serious disease, which must be treated very quickly. The earlier the condition is diagnosed, the better the chances are of a cure or relief from the symptoms.

What are the causes of pancreatic disorders?
Acute and chronic pancreatitis are true diseases of civilisation, while pancreatic cancer is normally a disease of old age. Both forms of pancreatitis are caused by over-indulgence in good food (fat) and alcohol. The food can cause gallstones, which in turn can cause acute pancreatitis. Likewise, alcohol can cause acute or chronic pancreatitis. Among the causes of pancreatic cancer are smoking and a diet containing too much fat and protein, while hereditary genetic factors are also of importance.

How is pancreatic cancer diagnosed?
Firstly by ultrasound examination, then with computerised tomography (x-rays), and thereafter magnetic resonance imaging (MRI). In rare cases, a gastroscopy is carried out, with the pancreas being examined using endoscopic retrograde cholangio pancreatography (ERCP).

How is pancreatic cancer treated?
This form of cancer can only be cured by surgery (removal of the tumour). Other forms of treatment can only relieve the symptoms (pain relief, improvement in digestion, insulin therapy etc.). Even chemotherapy cannot provide a cure, but can extend and improve the life of the patient.

What is acute pancreatitis?
This is an acute inflammation of the pancreas, triggered by gallstones, which block the pancreatic duct, or too much alcohol, which irritates the pancreas until it becomes inflamed. In rare cases, acute pancreatitis can be caused by drugs. Acute pancreatitis is always a dangerous illness and must always be treated in hospital. There is a risk that pancreatic enzymes will cause the body to digest itself (autodigestion)! 80% of cases of acute pancreatitis take a milder, less serious course, but 20% of cases are life-threatening.

What is chronic pancreatitis?
This is an inflammation of the pancreas which continues over years, causing severe pain. In 80% of cases, alcohol is the cause. The pancreas undergoes a drastic change over the course of the disease, with serious hardening and even calcification. This condition can lead to cancer developing. Abstinence from alcohol and pain relief therapy offers help, as does surgery in the later stages of the disease.

When is an operation on the pancreas required?
Surgery is required in the case of acute pancreatitis in its serious form, chronic pancreatitis in its later stages (after 3 to 5 years), or in the case of any tumours which are in their early stages, or in the medium stage, provided there are no secondary tumours, for example in the liver or lungs. Statistics show that every second patient with a pancreatic disorder requires surgery.

What are the risks of a pancreatic disorder or the related operation?
The risks of an operation are slight, provided the operation is performed in a major hospital which is highly experienced in this field. If the hospital does not have such experience, the risks are high!

When is a pancreas transplant performed?
This operation is only suitable for young people who are suffering from failure of the kidneys (dialysis) and the pancreas (diabetes) at the same time. All other patients are treated with insulin.

Can diabetes be cured by a transplant?
Yes, it can!

Can you live without a pancreas?
Yes.

If my pancreas is partly removed, will I automatically become a diabetic?
No. Diabetes only ensues if the more than 60 to 90% of the pancreas is removed.

Do you have to change your eating habits or diet after a pancreas operation?
As a rule, patients can eat normally. Following major pancreas operations, patients must cut down on their consumption of fats and take digestive preparations with every meal. The quality of life after pancreas operations is, however, very good.

Do people who have pancreatic disorders experience severe pain?
Until an operation is performed, yes, but afterwards severe pain is rare.

What is special about the medical care at the Pancreas Center Nordrhein-Westfalen?
The Pancreas Center has specialists who have devoted themselves to the treatment of pancreatic disorders intensively and have the vital experience in all aspects of these diseases that is so indispensable. Above all, the experience our specialists have of surgical procedures involving the pancreas is of the utmost importance for the long-term prognosis for our patients.

Who pays for the operation?
Normally, your health insurance will cover the costs. The Pancreas Center will be able to advise you.

How do I arrange a consultation with one of the pancreas specialists at the Pancreas Center Nordrhein-Westfalen?
If you send us an e-mail we will reply within 24 hours!

We answer as well personal questions by mail.