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CODS - Lap digestive

Laparoscopic Pancreatic Surgery (for benign tumors and cancer of pancreas)

Pancreatic tumours are two types endocrine and non-endocrine.

Most endocrine tumours are benign like insulinomas,gastrinomas,glucaganomas,vipomas and somastinomas. Malignant tumours include ductal adenocarcinoma and cystic adenocarcinoma.

Most of the benign tumours are asymptomatic,some present with hypoglycemia (low sugars),diarrhea, and ulcers in the GI tract.Endoscopic ultrasound localizes the tumour.

Laparoscopic excision of benign tumours (enucleation) gives good cure for more than 90 % tumours with combination of medicines for symptomatic relief.

Malignant tumours most commonly involve the head of pancreas present in late stages. Only 15 % tumours present in early stages. Symptoms are weight loss,jaundice, diarrhea and steatorrhoea. Laparoscopic Whipple operation (pancreatico duedenectomy with triple anastomosis-gastrojejunostomy, choledochojejunostomy, pancreaticojejunostomy) offers curative or palliative relief from the burden of the tumour. In inoperable tumours a triple bypass is done.

Chronic inflammation of pancreas leads to pancreatitis which results in pain, steateorrhoea and diabetes. Laparoscopic Puestows operation involving anastomosis between laid open pancreatic duct and jejunum relieves pain by allowing biliary drainage.