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Pancreatic Masses

The pancreas is a large organ that is located behind the stomach which functions as both a digestive and hormonal gland. It produces and releases enzymes during digestion which assist the body in absorbing foods, especially fats. The pancreas also makes insulin and glucagon, hormones which help the body regulate blood sugar levels.

What Pancreatic Masses?

Pancreatic Masses can be malignant process of the pancreas arising in the duct cells of the pancreas, however there are many different cell types of pancreatic masses. The most prevalent cells arising in the duct of the pancreas (adenocarcinoma) account for 80% of pancreatic cells. Many other cell types can present like pancreatic cells and can be confused with ampullary, duodenal, or bile duct mass cells, as well as other cells of the pancreas such as islet cell or neuroendocrine cells of the pancreas.

Pancreatic mass occurs when cells in the pancreas develop genetic mutations. These mutations cause the cells to grow and divide uncontrollably and to continue living after normal cells would die. These accumulating cells form a mass that can be seen on imaging studies such as CT scans or can cause alarming signs and symptoms such as jaundice.

Pancreatic masses can often have a poor prognosis, even when diagnosed early. A pancreatic mass can typically spread rapidly and is seldom detected in its early stages. Signs and symptoms of a pancreatic mass typically do not appear until they are quite advanced. Pancreatic mass symptoms:

• Upper abdominal pain

• Yellowing of your skin (jaundice), occasionally painless jaundice

• Loss of appetite

• Weight loss

Cause:

The cause is not clear.

Medical Treatment:

There are many different variables that depict the type of treatment you receive. Treatment is determined by the stage and location of the mass as well as on your age, overall health, and personal preferences.

• Radiation therapy - Radiation therapy uses high-energy x-ray beams to destroy cells.

• Chemotherapy - Chemotherapy uses drugs to help kill cells.

Definitive Treatment:

Surgery is the only hope for cure. It is an option only if the pancreatic mass is confined to the pancreas. Types of operations:

• Pancreaticoduodenectomy (often called a Whipple procedure): If your pancreatic mass is located in the head (or right side) of the pancreas.

• Distal pancreatectomy : Surgery for tumors in the pancreatic tail and body (or left side of the pancreas)

Other indications beyond cancer as to why people need a pancreatectomy:

• Mucinous cyst adenoma

• Intraductal papillary mucinous neoplasm (IPMN)

• Pancreatitis

Approach:

We have dedicated a large portion of our practice to progress in the treatment of pancreatic diseases, undertaking more than 1000 pancreatectomies and serving as lead investigators in many pancreatic disease trials. Given our extensive experience with pancreatic diseases, we have begun to focus the least invasive techniques on resecting pancreatic tumors: Laparo-Endoscopic Single Site (LESS) and robotically assisted surgery. Given our expertise and experience, we can now use the most Minimally Invasive Surgery, such as LESS surgery and robotic assisted approaches, for resection of pancreatic tumors and cancers. Qualification for a pancreatic tumor to be resected using minimally invasive techniques is dependent upon a multitude of factors: location of mass, proximity to vascular structures, tumor biology, patients medical status, and body mass index.

What to expect after an operation on your pancreas:

Some patients but not all experience one or more of the listed symptoms below:

  1. Loss of appetite
  2. Diarrhea – your remaining pancreas may be having difficulty adjusting for appropriate digestion. Please contact us should this occur
  3. Drains – as your body adjusts to postoperative changes it has associated inflammation. A drain is placed to assist in removal of the inflammatory fluid. The drain will be removed once there is minimal output.
  1. Discomfort at the incision for 1-7 days. Some level of discomfort is normal. If, however, you notice the incision to have redness, hot to the touch, discharge, increased pain, and/or fever, please call my office or come to our emergency room.
  2. Abdominal pain. This is the location of the actual operation and therefore it is normal to feel discomfort for several days.
  3. Fatigue – your body is recovering from a major operation and needs time to recuperate.
  1. Nausea and/or vomiting may occur after surgery for 1-2 days. This is usually related to general anesthesia administered during the operation.
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Sharona Ross, M.D. - Tampa Laparoscopic Surgeon
Located at 3000 Medical Park Dr, Suite 500 Tampa, FL 33613. View Map
Phone: (813) 615-7030
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