Chronic Pancreatitis

I have been diagnosed with Chronic Pancreatitis and since then have seen a gastro doctor.  He is recommending that I have my gallbladder removed, or as he stated "yank it out".  He has me on Urso 250mg @ 3 times a day; Nexium @ 40mgs; and Viokase 8 tab 5 times a day then given me percocet for when I am in pain.  First off, I am very concerned about removal of my gallbladder as a cure-all, it seems drastic.  He feels my gallbladder may be shooting sludge into my pancreas thus creating a pancreatic attack.  He is recommended that I fly to Virginia Mason Hospital for an ERCP and be prepared to have my gallbladder removed.  Also, since I started the Viokase I have been getting nauseated.  I had a sonogram done by my internist, he stated my liver looked a bit dense, but other than that he did see any gallstones.  I am scheduled for an abdominal ultrasound tomorrow, I'm assuming this is going to help determine which direction to go with me.  I have had pancreatic attacks since the age of 9 and it was not diagnosed until I was in my mid-20's as pancreatitis.  I have more frequent attacks now for some reason, about once every 3 months.  Is gallbladder surgery something you would consider at this point?    I am 36.

[Kevin Pho, MD]

Hello - thanks for asking your question.

The ERCP would be the test of choice for further evaluating the chronic pancreatitis.  Other alternatives would be an MRCP or endoscopic ultrasound.  The choice of test would be dictated by the specialist you will see.  

The option of surgery would be dependent on what they find on the ERCP - it is certainly possible.  Other possible options would include endoscopic therapy to relieve any blocked ducts or octrotide therapy (currently experimental).  It is difficult to speculate on what the treatment options are before the diagnostic tests are performed.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

It sounds as if you may have something wrong with the anatomy of your pancreas, rather than a gallbladder problem. It's the right step to have the pancreas evaluated more fully, and there are people at VM who are quite experienced with that. I'm sure ERCP would be part of it. Whether or not the gallbladder is playing a role, or if removing it has value remains to be seen, I'd say.

[jmess]

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[KrisCot]

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