Pancreatic surgery

Pancreatic surgery has developed from historically working with sutures towards use of sealing devices nowadays. Pancreatic diseases include abscesses, pseudocysts and tumors like insulinoma, glucagonoma, and adenocarcinoma. Pancreatitis, primarily a non-surgical disease, is the most common pancreatic disorder in dogs and cats. The most common disease of the endocrine pancreas is insulinoma, an insulin secreting βcell tumor.

When pancreatic disease is suspected, diagnostic steps after physical examination include complete blood count, serum chemistry profile, imaging, and biopsy for cytology and histopathology. Specific determinants of possible disease are abnormal concentrations or ratios of insulin, glucagon, and glucose. Serum pancreatic lipase immunoreactivity (PLI) concentration is currently considered to be the clinicopathological test of choice for the diagnosis of canine and feline pancreatitis (Xenoulis, 2015).

Although CT, MRI, SPECT, and ultrasonography are all clinically and experimentally available, until today intraoperative inspection and palpation of the pancreas is still superior compared to all imaging modalities (Robben et al., 2005).

Ultrasound guided aspiration of pancreatic pseudocysts is in the majority of cases succesful and the treatment of choice since several years. Pancreatic abscesses on the contrary should be treated by omentalisation. Prognosis for dogs with pancreatic abscesses is guarded with postoperative survival rates of 14-55%. [...]