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PANCREATIC DISEASES

Pancreatic cancer begins in the tissues of your pancreas — an organ in your abdomen that lies horizontally behind the lower part of your stomach. Your pancreas secretes enzymes that aid digestion and hormones that help regulate the metabolism of sugars.

Pancreatic cancer often has a poor prognosis, even when diagnosed early. Pancreatic cancer typically spreads rapidly and is seldom detected in its early stages, which is a major reason why it's a leading cause of cancer death. Signs and symptoms may not appear until pancreatic cancer is quite advanced and complete surgical removal isn't possible.

In Sri Lanka the incidence is rising and the incidence is 4 in 100000 population. The identified risk factors include smoking and alcohol.

At North Colombo teaching hospital we provide surgical management of full breadth of pancreas disease. We have performed over 100 pancreatectomies for cancer of the pancreas and other pancreatic diseases. The mortality figures in the unit are comparable to other tertiary referral centers in the world at 1%. The pancreatic leaks are at 1%, which is below the accepted level of 5%.

In addition the team provides management of pancreatitis and has been tertiary referral center for complex pancreatitis. In addition to surgery team provides ERCP support, which is an endoscopic management of management of pancreatits.

  • Management of Bile duct cancer and surgery of the Biliary tree

In addition to gallbladder surgery the Hepatobiliary department of the University Surgical unit provides surgical service for Bile duct disease including repair of bile duct injury and resection of bile duct cancer. This department is the tertiary referral centre in Sri Lanka for advanced bile duct cancer requiring surgery of the liver.

The unit has performed the highest number of liver resection for high bile duct cancers (Hilar cholangio carcinoma)

  • Endoscopic Retrograde Cholangio Pancreatography(ERCP)

ERCP stands for 'endoscopic retrograde cholangiopancreatography'. ERCP is a very useful procedure, as it can be used both to diagnose and to treat various conditions, such as gallstones, acute pancreatitis (inflammation of the pancreas that develops quickly over a few days) and chronic pancreatitis (inflammation of the pancreas that is more persistent).

An endoscope is a thin, flexible, telescope. It is passed through the mouth, into the gullet (oesophagus) and down towards the stomach and the first part of the gut after the stomach (the duodenum). The endoscope contains fibre-optic channels, which allow light to shine down so the doctor can see inside.

Cholangiopancreatography means X-ray pictures of the bile duct and pancreatic duct. These ducts do not show up very well on ordinary X-ray pictures. However, if a dye that blocks X-rays is injected into these ducts then X-ray pictures will show up these ducts clearly. Some dye is injected through the papilla back up into the bile and pancreatic ducts (a 'retrograde' injection). This is done via a plastic tube in a side channel of the endoscope. X-ray pictures are then taken.

We perform ERCP for Hepatobiliary pancreatic disease and perform advanced procedures in liason with the National Hospital of Sri Lanka Gastrointestinal and Hepatology unit.

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