The pancreas is an elongated, lobular multi-function glandular organ in the digestive system that lies on the posterior abdominal wall behind the stomach. Surrounded by the liver, spleen, gallbladder, and the small intestine, a part of it is wedged between the spine and the stomach while the other part, called the head, is connected to the first part of the small intestine (duodenum). It has an endocrine function as it produces several important hormones such as somatostatin, insulin, glucagon, and the pancreatic polypeptide that circulate in the blood. It is also a part of the digestive system and secretes enzymes or digestive juices to further break down food.
Anatomically, the pancreas, which shape resembles a tadpole, is divided into:
- The head – This is the widest part of the organ and lies within the concavity of the duodenum. This is where the stomach empties partially digested food mixed with digestive enzymes released by the pancreas into the small intestine. Part of the head is the uncinate process, which develops from the ventral pancreatic fluid and hooks around the superior mesenteric vein and mesenteric artery.
- The body – This is the largest part of the organ that rests on the base of the stomach.
- The tail – This part is located near the hilum of the spleen. It contains the pancreatic polypeptide, which inhibits pancreatic enzyme secretion and gallbladder contraction.
The pancreas develops from two separate primordial; the dorsal and ventral pancreas with the former appearing first and generating most parts of the organ. This is followed by the development of the ventral pancreas beside the bile duct that forms the organ’s head and uncinate process. The two separate primordials then fused and form the pancreas, which exocrine function begins immediately after birth while its endocrine function or hormone release is only measurable after 10 weeks. During development, the pancreas rotates to the left due to the differential growth of the stomach walls while the stomach and the liver undergo a lot of growth as well. This causes the parts of the pancreas to rotate around the duodenum.
Common Pancreatic Diseases/Conditions
Pancreatitis –This condition, which can be either acute or chronic, refers to the inflammation of the pancreas, and is often caused by alcohol abuse, cystic fibrosis, abdominal surgery, gallstones, high calcium levels in the blood, and certain medications.
Pancreatic cancer – Cancer of the pancreas develops when a cell in the organ has become damaged and starts to multiply rapidly. There are different types of pancreatic cancer with adenocarcinoma of the pancreas being the most common. Meanwhile, adenosquamous carcinoma and squamous cell carcinoma are very rare.
Exocrine Pancreatic Insufficiency (EPI) – This occurs when there’s not enough supply of pancreatic exocrine enzymes resulting in maldigestion or inability to digest food properly.
Pancreas Divisum – This is a common congenital condition in which the dorsal pancreas and the ventral pancreas fail to fuse together.
Diabetes (Type 1) – This is an autoimmune condition wherein the body’s immune system attacks the pancreas’ insulin-producing cells.
Diabetes (Type 2) – This is a long-term metabolic disorder in which glucose builds up in the bloodstream due to the pancreas’ inability to produce and release enough insulin.
Common Pancreas Procedures and Surgeries
Whipple’s procedure – This is the standard surgical treatment for pancreatic cancer in which the head of the pancreas, duodenum, the gallbladder and sometimes, a small part of the stomach, are surgically removed.
Pseudocyst surgery –This procedure, which can be performed using either traditional or minimally invasive technique, removes pseudocyst, a fluid-filled cavity that resembles a cyst.
Pancreas transplantation – This is considered when the damage to the pancreas is irreversible and the organ no longer functions properly. This is a surgical treatment in which a diseased pancreas is removed and replaced with a healthy pancreas from a deceased donor.
Islet cell transplantation – This is an experimental procedure in which insulin-producing cells harvested from a donor pancreas are transplanted into patients with type 1 diabetes to eliminate the need for insulin treatment.