Treatments for Pancreatitis

Acute Pancreatitis

Treatments for acute pancreatitis include both supportive and surgical methods.  Patients are given fluids to hydrate their body.  They also may be given intravenous nutrition to rest their bowel.  Antibiotics are taken and patients may also be on dialysis or a respirator.  Surgical methods for treating acute pancreatitis include endoscopic interventions, removal of the gallbladder, or drainage of pseudocyst.

Treatments for acute pancreatitis include therapy administered during hospitalization.  In severe cases, the therapy may need to be administered in the intensive care unit.

Most patients recover from the acute event and will not relapse if the original cause can be corrected (e.g. gallbladder removed if there are stones, refrain from alcohol for lifetime).  A percentage of patients will go on to develop chronic pancreatitis with scarring in the pancreas and persistent pain.  If analgesics are required to diminish the pain, than the patient is a candidate for endoscopic intervention to try to unblock scar tissue in the duct, or for surgical intervention, including partial or total pancreatectomy.  A partial or total pancreatectomy may be needed to relieve pain, and in order to prevent diabetes that would result from removing the pancreas, an islet autograft could be performed as well.

Chronic Pancreatitis

The types of treatment for chronic pancreatitis depend on the cause of the disease, the success of former treatment options, and the severity of the pain.  Treatment options may include:

    - correcting nutritional deficiencies,
    - eliminating alcoholic beverages,
    - analgesics or narcotics for pain,
    - enzyme therapy,
    - treating diabetes, if needed.

If a person is not responding to treatment or is experiencing the long-term pain of chronic pancreatitis and its complications, their doctor may recommend surgery on the pancreas such as:

    - drainage procedures (such as a Puestow);
    - partial resections (such as a Whipple procedure, where the head of the pancreas is removed or a distal pancreatectomy, where the tail of the pancreas is removed);
    - removal of the pancreas (also called a pancreatectomy);
    - pancreatectomy and auto islet transplant.

Read more about these procedures in Top5plus5's Pancreatitis Library.

Removal of the pancreas (a pancreatectomy) is most likely to relieve pain; however, it induces diabetes in the patient.  A patient who has a pancreatectomy will need to take insulin shots or be on an insulin pump for the rest of their life.

In an attempt to prevent diabetes in patients who undergo a pancreatectomy, Dr. David E.R. Sutherland at the University of Minnesota began performing pancreatectomy and auto islet transplants in 1977.  With this procedure, the patient's pancreas is removed and islets are isolated from their pancreas.  Then, the patient's own islets are transplanted back into their body.  Islets produce insulin.  A person who has a pancreatectomy and auto islet transplant has a 50% chance of not being diabetic after their surgery.  Whether or not they become diabetic depends on a number of factors including the number and quality of islets isolated from their pancreas.  Therefore, the probability that a person will not need insulin shots after a pancreatectomy and auto islet transplant is highest in patients who have had no previous surgery on the body and tail of the pancreas (such as a Whipple or Puestow).  Since there is no guarantee that people who have the pancreatectomy and auto islet transplant will not become diabetic, patients have to accept the possibility of becoming diabetic when they have the surgery.  If diabetes is prevented, that is a bonus.