Pancreatitis is caused by inflammation and infection of the pancreas due to a multitude of causes. Postoperative pancreatitis is considered a form of acute pancreatitis. The best understanding of what occurs during acute pancreatitis is that digestive enzymes that are typically released in the inactive form somehow become activated and begin digesting the pancreas. The pancreas is important because it releases insulin and glucagon, two important hormones.
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Causes
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Postoperative pancreatitis typically occurs after surgical manipulation of the pancreas and is a common complication after the removal of insulinomas, malignant tumors of the pancreas. After surgery to remove insulinomas, it is important to not give anything orally because doing so stimulates pancreas activity. Monitoring for pancreatitis is crucial during this time; as long as no symptoms are present, oral intake can gradually be introduced.
Symptoms
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Postoperative pancreatitis is a form of acute pancreatitis. Vomiting and abdominal pain are the two most common symptoms. Hypoglycemia is a dangerous symptom that should be monitored and addressed throughout the time period of potential and actual pancreatitis. The pancreatic enzymes amylase and lipase serum concentrations will confirm the presence of pancreatitis.
Treatment
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Following a pancreatectomy, a patient is treated for the first 24 to 48 hours as though it does have pancreatitis. Intravenous fluid therapy is an important component to postoperative treatment as well as giving nothing orally to avoid stimulating the pancreas. Especially when removing insulinomas, it is important to monitor and maintain optimal blood glucose because hypoglycemia may occur and is life threatening.
Prognosis
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The prognosis of postoperative pancreatitis depends largely on how long a dog has had pancreatitis before diagnosis and treatment. Since pancreatitis involves the digestive enzymes becoming activated and digesting the pancreas, early detection is extremely important to maintain function of the pancreas. A dog cannot survive without his pancreas, so any irreversible damage will lead to a guarded or grave prognosis.
Prevention
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Postoperative pancreatitis is largely due to complications during recovery from surgery that requires manipulation of the pancreas and is not something that can be avoided since there isn't a clear reason why some patients are afflicted and some aren't. Insulinomas are also not distinctly preventable. Insulinomas are a dangerous form of cancer as they cause hypoglycemia and should be removed for the best effective treatment. Postoperative pancreatitis is not as risky as leaving insulinomas in the pancreas and is not a reason to avoid surgical removal.
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