The pancreas is a dual-function organ with both exocrine and endocrine roles. The endocrine function is to release insulin for glucose management. On the other hand, the exocrine pancreas secretes enzymes like trypsin to aid in the digestion of food. Hence, it plays a vital role in energy metabolism, diabetes management and digestion. However, in cases of acute pancreatitis or cancer, experts may advise removing the pancreas. They say that living without a pancreas may be challenging, but it is possible with proper diet and lifestyle modifications.
Medical experts usually refer to the pancreas as a sleeping tiger. If disturbed, it can suddenly attack the body. And the consequences can be so severe that it can require removing a part or the entire organ.
When is the pancreas removed?
Poor habits like excessive consumption of alcohol can affect not only the liver but also the pancreas. Dr Omar Khokhar, gastroenterologist, OSF HealthCare, Illinois, USA, says, “Smoking, alcohol and gall stones can cause pancreatic inflammation called pancreatitis. If your pancreatic function is compromised due to chronic inflammation, you can take pancreatic enzyme replacements. In cases of pancreatic cancer or pancreatic cysts causing severe pain, only a portion of the pancreas is removed.”
In the case of chronic pancreatitis that cannot be medically managed, experts may advise removing the organ. Professor Dr Neelamekam Thoppa Kapali, HOD – gastroenterology and liver transplant surgeon, Fortis Malar, Chennai, explains, “The pancreas can be removed due to periampullary carcinoma of the pancreas (tumor on the head of the pancreas) or due to the presence of neuroendocrine tumors. We then perform a pancreaticoduodenectomy or the Whipple procedure, a complex surgical procedure that involves removing almost two-thirds of the pancreas along with a part of the stomach, bile duct and duodenum.”
Dr Rajesh Khadgawat, professor, endocrinology, AIIMS, New Delhi, says, the pancreas is the only source of insulin in the body. “Hence, if you remove it, the body cannot produce insulin, which can lead to diabetes. One may not survive unless insulin injections are taken,” he adds.
Born without a pancreas
In extremely rare cases, children might be born without a pancreas, causing diabetes at birth. The congenital issue is called agenesis (lack or failure of development) of the pancreas. Dr Kapali explains during the development of the fetus, the pancreatic duct may not be properly formed, which is known as pancreatic divisum. It can cause acute or chronic pancreatitis. “When someone comes with this kind of a problem, then we may have to remove the pancreas,” he shares.
Living without a pancreas
Once the organ is removed, one will have to be on life-long treatment, which includes pancreatic enzyme supplements and insulin, highlights Dr Khadgawat. He adds, “Both enzymes and insulin inadequacy can be managed with medication. But ill health may persist, affecting the quality of life.” If proper care is not taken, the person can develop hyperglycemia or hypoglycemic coma. The kidney might also be affected.
Dr Kapali adds, “In the case of a completely dead pancreas (when there are not enough beta cells and insulin is not produced), pancreatic or beta cell transplantation might be suggested. However, this can be a major financial drain for the person. Moreover, pancreas transplantation alone might not provide the best results. But with cluster transplantation (pancreas and kidney transplantation), usually performed when the kidneys are also affected, better outcomes are seen.”
Can you live a long life without pancreas?
The body is an integrated system. When one organ gets affected, it takes a toll on the other parts of the body, too. Dr Kapali says with better technology and drugs, one can manage to lead a regular life and the risk of mortality is mostly due to other health conditions unrelated to the pancreas. People may develop cardiac or kidney issues. But proper lifestyle choices like good exercise, good food, balanced diet, will help.
- The pancreas helps in digestion, energy metabolism and diabetes management.
- The pancreas can be removed in cases of pancreatic cancer, severe pancreatitis or pancreatic cysts causing pain.
- Once removed, one is more likely to develop diabetes. People can require life-long enzyme supplements and insulin to manage their diabetes.
- There is a risk of developing hyperglycemia, hypoglycemic coma, and kidney and cardiac issues after the removal of the pancreas. However, one can lead a regular life with proper medical care and lifestyle modifications.