How is pancreatitis treated?

Patients with acute pancreatitis are primarily given intravenous fluids and pain medications in the hospital. In up to 20 percent of patients, the pancreatitis can be severe and patients need to be admitted to an intensive care unit (ICU). In the ICU, the patient is closely monitored, since pancreatitis can cause damage to the heart, lungs, or kidneys. Some cases of severe pancreatitis can result in death of pancreatic tissue. In these cases, surgery may be necessary to remove the damaged pancreatic tissue.

An acute attack of pancreatitis usually lasts only a few days, unless it is caused by gallstones. An acute attack of pancreatitis caused by gallstones may require removal of the gallbladder or endoscopic surgery of the bile duct.

Pancreatic surgery can be performed as a laparoscopic or "minimally invasive" procedure. During laparoscopic surgery, five or six small (5 to 10 millimeter) incisions (cuts) are made in the abdomen. The laparoscope and surgical instruments are inserted through these incisions. The surgeon is guided by the laparoscope, which transmits a picture of the internal organs on a monitor. The advantages of laparoscopic surgery include smaller incisions, less risk of infection, pain, and scarring, and a more rapid recovery.

The need for surgery is determined by the severity of the pancreatitis. After the gallstones are removed and inflammation subsides, the pancreas usually returns to normal.

Chronic pancreatitis can be somewhat difficult to treat. Doctors will primarily try to relieve the patient's pain and improve the nutritional and metabolic problems that result from loss of pancreatic function. Patients are generally given pancreatic enzymes and insulin, since these substances are not being secreted or released by the pancreas. Pancreatic enzyme pills are usually prescribed to be taken before meals to aid in nutrient absorption. A low-fat diet may also be helpful.

Surgery may be necessary to relieve abdominal pain, restore drainage of pancreatic secretions, treat chronic pancreatitis caused by blockage of the pancreatic duct, or to reduce the frequency of attacks.

Patients must stop drinking alcoholic beverages, follow their physician's and dietitian's dietary recommendations, and take the proper medications in order to have fewer and milder attacks of pancreatitis.

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