Introduction
When treating pancreatitis, a distinction must first be made between the type of disease and the type of pancreatitis. The doctor treating the patient must therefore determine whether the pancreatitis can be treated by either
- Acute or the
- Chronic form of the disease. – conservative (non-surgical)
- Endoscopic (minimally invasive) or
- Through an operation.
Acute pancreatitis
Since acute pancreatitis is usually accompanied by severe pain and involves serious risks, treatment is always carried out in hospital. In the case of very severe forms of pancreatitis, a stay in an intensive care unit is unavoidable. In quite a few cases, such a disease results in a so-called circulatory shock, in which the patients concerned are given blood preserves and/or infusions to compensate for the drop in blood pressure.
In order to relieve the severe pain, people suffering from acute pancreatitis receive antispasmodic and analgesic drugs, which are usually administered to the body via the vein. Furthermore, in the course of glandular relief, it is necessary to refrain from eating for a certain period of time (2 – 5 days). During this period, the increase in fluid and nutrients is completely via the blood or a small intestine tube.
In this way, the natural digestive system, including the pancreatic enzymes, is bypassed. After the symptoms and relevant blood values have improved, a therapy phase begins in which the slow build-up of food is begun. The patient is given a light, light diet for a few days, which is then supplemented.
In many cases, it is also useful to administer enzyme preparations to the patient to further relieve the pancreas. Alcohol should never be consumed during the entire treatment period. In severe forms of acute pancreatitis, it is advisable to take an antibiotic to minimise the risk of infection.
In the course of an acute pancreatitis, a lot of tissue can die off. In such cases, the non-surgical therapeutic measures are not sufficient to remedy the critical situation of the patient. The dead pancreatic tissue must be surgically removed.
Chronic pancreatitis
Since the consumption of alcohol plays a major role in the development of chronic pancreatitis, it is imperative that these patients abstain from alcohol throughout their lives. In most cases, a diet and a change in food intake also leads to a significant improvement in symptoms and ultimately to recovery of the pancreatic tissue. People who suffer from this form of pancreatitis are supplied with pancreatic enzymes and various vitamins (for example vitamins A, D, E and K; fat-soluble vitamins) from outside for the rest of their lives.
This measure results in a permanent relief of the gland, as it only has to and/or can produce fewer enzymes itself. During the acute phases, which occur intermittently, this form of the disease is treated in the same way as a normal acute pancreatitis. Non-operative treatment measures are not always sufficient to keep the patient symptom-free.
Now it becomes necessary to resort to surgical interventions. The treating surgeon can, if necessary
- Widen the narrowed ducts of the pancreas,
- Create an artificial passage to the small intestine and/or
- Remove dead parts of the pancreatic tissue. If the pancreatitis is caused by gallstones that block the common bile duct and the pancreas (ductus choledochus), they must be removed.
This is now done by means of an endoscope. This is advanced through the intestine to the exit point of the choledochal duct in the duodenum. The exit point is now opened with a small incision so that the stones can exit.
In the case of a pancreatic abscess (accumulation of pus due to bacterial inflammation), it is suctioned out and then rinsed. An abscess is an encapsulated accumulation of pus. – If the pancreatitis is caused by gallstones that block the common bile duct and the pancreas (ductus choledochus), they must be removed.
This is now done by means of an endoscope. This is advanced through the intestine to the exit point of the choledochal duct in the duodenum. The exit point is now opened with a small incision so that the stones can exit.
