The pancreas is a very important organ in the human body. The purpose of this endocrine gland is the production of insulin, which regulates the exchange of glucose in the body, the synthesis of digestive enzymes, storage and elimination of hormones.
Does the pancreas work, in which cases is it required to transplant it?
This organ undergoes surgical intervention, like other organs, if urgently needed. Indications for transplant can be:
1) diabetes( I and II type);
2) secondary diabetes:
a) caused by damage( pancreatitis, cancer, hemochromatosis);
b) appeared due to hormonal disorders that cause resistance to insulin - gestational diabetes, Cushing's syndrome, acromegaly;
3) end stage nephropathy;
4) hyperlabile diabetes;
5) Pre-Rheumatic Diabetic Nephropathy;
6) endocrine and exocrine insufficiency( violation of the secretion of insulin and other hormones and trypsin, necessary for intestinal digestion).
The pancreas is a very complex organ. Today there are more than 200 cases of its replacement for getting rid of diabetes. Transplantation of individual cells - "islet cells", which produce insulin has become more widespread.
Technically, pancreas transplantation is associated with many difficulties, it is advisable to transplant it together with the duodenum. Iron is very sensitive to physical effects, even touching a finger can injure it. And during the operation it is necessary to sew a large number of vessels.
The operation to remove the pancreas and replace it with another healthy one also has problems with the biological plan - because of the high activity of the trypsin enzyme, the "self-digestion" of the gland can occur.
If in the kidney transplant this organ is taken from a living donor, then because of the incompatibility it is possible to get it for transplantation only from the corpse. In addition, this body, because of its high sensitivity to oxygen deficiency, suffers only short-term( not more than 30 minutes) cessation of blood flow. With the help of special methods of cold preservation, the organ intended for transplantation can be stored for no more than 2-3 hours, in exceptional cases - 6 hours. This complicates the selection of an adequate "donor-recipient" pair.
The first operation for pancreatic transplantation simultaneously with the duodenum was carried out in 1967 abroad. In our country, a pancreas and kidney transplant was subsequently transplanted to a patient with diabetic nephropathy.
In modern medicine, the problems of transplanting this organ are being studied very intensively. The most effective surgical operations are developed, the possibility of replacing only the tail part of the gland and the introduction of various plastic elements into its ducts is investigated.
What is the prognosis of the operation on the pancreas? Over the past decade, this forecast has become much more optimistic. The indicator of the effectiveness of such operations has increased, the risks of complications have decreased. Thus, 85% of operated patients retain all the functions of the transplanted organ.
Most patients are interested in the question: what is the cost of a pancreas transplant operation? Of course, the price of such a transplantation today is quite high - both in our country and abroad. This is due to both the technical side of the operation and the correction of the postoperative process, in which, despite favorable forecasts, there may be difficulties. And, the main component of the high cost of replacing this organ is a limited amount of this biological material.
Types of operations on the pancreas
Surgical intervention in the treatment of the pancreas can be of several types, one of which is the suturing of the affected organ. This operation is possible if minor damage occurs along the edges of the organ, which can disrupt its integrity. Sewing is done with non-absorbable threads, after which drainage is put.
In more complex pancreatic injuries, surgeons use a deeper operation called "necrectomy."It is necessary in cases of purulent acute pancreatitis, accompanied by extensive inflammation. The patient in such cases is in extremely serious condition and any delay or error in measurements can lead to profuse bleeding and suppuration of the accompanying organs.
When a pseudocyst is detected on the pancreas, cystoenterostomy is used. This type of operation allows you to eliminate existing partitions or pockets located in the cyst cavity, all this is possible only in the absence of even a minimal suppuration.
If cysts are suppurating, then they operate using the method of marsupialization. In this case, the cyst is to be opened, and its purulent contents - to immediate elimination. The cyst itself is sewn to the abdominal cavity.