Pancreatitis: Surgery

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Surgery

Surgery to remove gallstones can relieve sudden (acute) pancreatitis caused by gallstones that are blocking the common bile duct. The gallbladder may be removed later to prevent future attacks from gallstones .

Surgery of the pancreas is avoided, if possible, because the gland is easily damaged. But surgery may be needed to remove infected or damaged tissue (pancreatic necrosis).

Several surgical procedures can be used to try to reduce pain in chronic pancreatitis. These procedures include removing stones from the pancreas, draining blocked ducts, and destroying certain nerves to reduce pain. But results vary, and surgical treatment of chronic pancreatitis may not be effective.

Surgery Choices

One of two surgeries can be done to remove the gallbladder if gallstones are causing pancreatitis:

• Laparoscopic gallbladder surgery
• Open gallbladder surgery

Endoscopic retrograde cholangiopancreatogram (ERCP) is a procedure used to remove one or more gallstones from the common bile duct.

Surgeons may choose among several techniques to remove damaged pancreatic tissue.

What To Think About

Gallstones sometimes form in the bile ducts years after surgery to remove the gallbladder (cholecystectomy).

Doctors debate how soon someone with damaged tissue that is infected (infected pancreatic necrosis) should have surgery. Generally, doctors try to wait at least a week because the pancreas is easily damaged. The outcome is better if surgery can be postponed until inflammation goes away.⁶

Studies have shown that having surgery early in the course of pancreatitis does not improve survival rates.⁷

Surgery has the potential for complications, including infection, bleeding, and artificial openings (fistulas) that can develop between the pancreas and the small intestine or other organs.

Survival after surgery depends on many factors, including your overall health and age (older people have a higher death rate), the extent of pancreatic necrosis, and whether the tissue is infected.

Last updated:	July 02, 2007
Author:	Monica Rhodes
Reviewed By:	Kathleen Romito, MD - Family Medicine, Brent Shoji, MD - General Surgery
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC