Chronic Pancreatitis

Chronic pancreatitis can be very painful. Our experts specialize in treating this condition and work tirelessly to help our patients find much-needed pain relief. UCLA’s Agi Hirshberg Center for Pancreatic Disease is also one of only a few places nationwide where patients can receive auto-islet transplant for chronic pancreatitis.

What Is Chronic Pancreatitis?

Chronic pancreatitis is a painful inflammatory disease that destroys pancreatic tissue and replaces it with scar tissue. Over time, this condition can damage your body’s ability to produce digestive enzymes (juices) and hormones like insulin that control blood sugar.

Chronic pancreatitis is categorized as either alcoholic pancreatitis or idiopathic pancreatitis.

Alcoholic Pancreatitis

Alcoholic pancreatitis is a progressive disease that may worsen even after a patient stops drinking. An episode of binge drinking can cause an attack similar to acute pancreatitis. In these cases, alcohol has likely permanently damaged the pancreas.

Idiopathic Pancreatitis

Up to 30 percent of chronic pancreatitis cases have no apparent cause and are labeled idiopathic. Up to half of these patients will be pain-free, but other symptoms may still be present.

What Causes Chronic Pancreatitis?

Alcoholism is the main cause of chronic pancreatitis, representing roughly three in four cases in the U.S.

Chronic Pancreatitis Symptoms

Symptoms of chronic pancreatitis include:

• Abdominal pain
• Weight loss
• Bulky, fatty or oily stools
• Pancreatic calcifications (small, hardened calcium deposits in the pancreas)
• Exocrine insufficiency (when the pancreas is unable to produce digestive enzymes, making it difficult for patients to digest food)
• Endocrine insufficiency (when the pancreas can’t produce hormones that control blood sugar, which can ultimately cause patients to develop diabetes)

Diagnosing Chronic Pancreatitis

Your doctor may order an imaging test, such as X-ray, CT (computerized tomography) scan or MRI (magnetic resonance imaging), to look for calcifications that indicate chronic pancreatitis.

Minimally invasive interventional endoscopy (using a thin, flexible tube inserted into the digestive tract) can also help doctors see inside the pancreatic duct and bile duct. UCLA has the largest team of interventional endoscopy specialists in Los Angeles, helping more patients get answers without the need for surgery.

In certain cases, it can be difficult for doctors to tell between chronic pancreatitis and pancreatic cancer. When a patient is pain-free but exhibits symptoms like jaundice (yellowing of the skin and eyes) and weight loss, surgery may be needed to make the diagnosis.

Chronic Pancreatitis Treatment

The first step in treating pain associated with chronic pancreatitis is to immediately stop drinking and smoking. Up to 50 percent of patients experience some pain relief when they stop drinking alcohol.

However, pain may continue for those whose disease has damaged the pancreas. If pain is interfering with your quality of life by causing problems like frequent hospitalization or depression, your doctor may recommend surgery.

There are three types of surgery to relieve pain in chronic pancreatitis patients:

• Puestow procedure: This is a drainage operation for patients with an enlarged pancreatic duct. UCLA’s surgical team has extensive experience with the Puestow Procedure, which isn’t commonly done at many facilities.
• Pancreatic resection: When the pancreatic duct is normal or narrow, or where pain comes back after a Puestow, doctors may recommend pancreatic resection. This involves surgical removal of part or all of the pancreas. In cases of total pancreas removal (pancreatectomy), patients may be eligible for auto-islet transplant to minimize lifelong insulin dependence.
• Frey procedure: Newer operations like the Frey Procedure combine drainage with limited resection and may have fewer side effects. Our expert surgeons have experience in this procedure, which is not commonly performed at other hospitals.

Learn more about chronic pancreatitis treatments.

Auto-Islet Transplant for Chronic Pancreatitis

While other surgeries for chronic pancreatitis vary in their ability to provide successful pain relief, total pancreatectomy can completely resolve pain associated with the condition. However, this leaves patients without the ability to produce insulin and is typically only used when other treatments have failed.

UCLA is one of just a few hospitals nationwide offering auto-islet transplant for patients who undergo pancreatectomy for chronic pancreatitis. After removing the pancreas, specialists transplant insulin-producing cells from the pancreas to the liver. This procedure often eliminates or reduces the need for insulin injections.

Learn more about UCLA’s auto-islet transplant program.