Chronic Pancreatitis Treatments
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UCLA is the only hospital in the Southwest that offers auto-islet transplant. What’s more, our surgical team is one of the most experienced in the region, which means better outcomes and more treatment options for our patients.
Chronic Pancreatitis Treatment at UCLA
We offer comprehensive treatment options for chronic pancreatitis, including minimally invasive pancreatic surgery. Minimally invasive pancreatic surgery often means shorter recovery times for our patients. Our expert team performs roughly 150 pancreatic surgeries each year.
We also offer procedures uncommon at smaller hospitals with a level of experience that minimizes post-surgical complications. Chronic pancreatitis surgeries available at UCLA include:
Puestow Procedure
Chronic pancreatitis can cause blockage in the pancreatic duct. The Puestow procedure (pancreaticojejunostomy) is an operation used to drain an enlarged pancreatic duct.
During this procedure:
- Your surgeon opens the main pancreatic duct.
- Your surgeon then connects the duct to the jejunum, part of the small intestine.
- This allows pancreatic juices to drain while leaving the pancreas and duodenum (first part of the small intestine) intact.
Common questions about this surgery include:
- Will I have diabetes after a Puestow procedure?
- Answer: The operation itself doesn’t necessarily result in diabetes. In fact, it may even improve pancreas function. That said, you may end up needing insulin if the disease continues destroying pancreatic tissue after the operation.
- Will the Puestow procedure relieve my pain?
- Answer: This operation relieves pain in 75 to 80 percent of patients in the first several years after surgery. However, pain may occur again. Only 60 to 70 percent of patients report pain relief after five years. These patients may need additional surgery.
Frey Procedure
This is a relatively new operation combining drainage and limited resection (removal of pancreatic tissue), with potentially fewer side effects.
During this procedure:
- Your surgeon opens up the head of the pancreas.
- Your surgeon then removes diseased areas of the pancreatic duct within the head of the pancreas.
- This allows pancreatic juices to drain normally while leaving the rest of your pancreas and duodenum (first part of the small intestine) intact.
This procedure is typically used in patients where the main blockage is in the head of the pancreas.
Common questions about this surgery include:
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- Will I have diabetes after a Frey Procedure?
Answer: There is a lower risk of developing diabetes after a Frey Procedure compared to pancreatic resection.
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- Will the Frey Procedure relieve my pain?
Answer: The Frey Procedure is more likely to result in permanent pain relief compared to other surgeries for chronic pancreatitis.
Pancreatic Resection
Pancreatic resection involves removing part or all of the pancreas. Doctors may recommend pancreatic resection to surgically remove part of the pancreas for several reasons. These reasons include:
- The pancreatic duct is not enlarged.
- A previous Puestow Procedure has failed.
- Your disease only affects one area of the pancreas.
Common questions about pancreatic resection include:
Will I have diabetes after a pancreatic resection?
Answer: These operations are more likely to result in diabetes compared to the Puestow and Frey procedures.
Will it relieve my pain?
Answer: About 85 percent of patients report pain relief in the first several years after pancreatic resection. Pain relief is more likely permanent compared to Puestow and Frey procedures, with roughly 80 percent of patients staying relatively pain-free after five years.
UCLA does more pancreatic surgeries than anyone else in the region, performing roughly 150 of them every year. Research shows outcomes are better at major medical centers performing a high volume of pancreatic surgeries like ours, including lower mortality and complication rates.
Pancreatic resection procedures available at UCLA include:
Whipple Procedure (Pancreaticduodenectomy)
The Whipple procedure is a complex procedure involving the removal of the head of the pancreas, the bile duct, the gallbladder, part of the small intestine and part of the stomach. Surgeons then reconnect the rest of the pancreas and nearby organs to the digestive tract. Patients are typically hospitalized for 7 to 10 days.
Patients at facilities performing more than 20 Whipple procedures annually experience fewer complications, like blood loss and post-surgical infection. UCLA performs roughly 100 Whipple procedures each year, with consistently lower rates of blood loss than other major medical centers.
Minimally Invasive Pancreatic Surgery
Our surgeons use minimally invasive laparoscopic surgery whenever possible. This procedure allows surgeons operate using several small holes instead of a large incision.
For patients, laparoscopic surgery means a lower risk of complications, like blood loss and infection. It also means spending less time in the hospital to recover.
Minimally invasive pancreatic cancer surgeries at UCLA include:
Distal Pancreatectomy
UCLA offers minimally invasive distal pancreatectomies performed laparoscopically. Surgeons remove the body and tail of the pancreas and also remove the spleen.
Because the spleen helps your body ward off infection, you may need certain vaccines before and/or after surgery. Recovery in the hospital typically lasts for 5 to 7 days.
Total Pancreatectomy
Total pancreatectomy may be used when other treatments have been unsuccessful. The surgery removes the entire pancreas as well as the spleen and gallbladder.
Removing the pancreas leaves patients unable to produce pancreatic enzymes (digestive juices) or insulin. After this surgery, patients must take supplemental enzymes and insulin, unless the patient also receives an auto-islet transplant.
Auto-Islet Transplant
Patients who undergo total pancreatectomy may be eligible for auto-islet transplant. UCLA is the only hospital in the Southwest that offers this innovative procedure.
The procedure transplants insulin-producing cells from the patient’s pancreas into the liver, often reducing or eliminating the need for lifelong insulin injections.
Learn more about auto-islet transplant.