{"id":183,"date":"2018-11-07T18:26:20","date_gmt":"2018-11-07T16:26:20","guid":{"rendered":"https:\/\/www.barnaclinic.com\/blog\/cirugia-del-pancreas\/ca\/?p=183"},"modified":"2018-11-07T18:26:20","modified_gmt":"2018-11-07T16:26:20","slug":"consequencies-extirpacio-del-pancrees-insuficiencia-pancreatica","status":"publish","type":"post","link":"https:\/\/www.barnaclinic.com\/blog\/cirugia-del-pancreas\/ca\/consequencies-extirpacio-del-pancrees-insuficiencia-pancreatica\/","title":{"rendered":"Quines s\u00f3n les conseq\u00fc\u00e8ncies despr\u00e9s de l’extirpaci\u00f3 parcial o total del p\u00e0ncrees? La insufici\u00e8ncia pancre\u00e0tica"},"content":{"rendered":"

El\u00a0p\u00e0ncrees<\/strong><\/a>\u00a0presenta diverses funcions, entre les quals es troben: la\u00a0funci\u00f3 de control dels nivells de sucre en sang<\/strong>\u00a0(funci\u00f3 endocrina)<\/strong>\u00a0i la funci\u00f3 digestiva<\/strong>\u00a0(funci\u00f3 exocrina).<\/strong><\/span>\u00a0La\u00a0funci\u00f3 del p\u00e0ncrees<\/strong>\u00a0es reparteix de forma asim\u00e8trica al llarg de tota la gl\u00e0ndula;<\/span>\u00a0aix\u00ed, al\u00a0cap del p\u00e0ncrees<\/strong>\u00a0predomina la funci\u00f3 exocrina,<\/strong>\u00a0mentre que al cos i la cua predomina la funci\u00f3 endocrina.<\/strong><\/span>\u00a0Aix\u00f2 no vol dir necess\u00e0riament que, despr\u00e9s d’una intervenci\u00f3 quir\u00fargica d’extirpaci\u00f3 del cap o del cos i la cua, el pacient vagi a presentar irremeiablement una\u00a0insufici\u00e8ncia pancre\u00e0tica<\/strong>.<\/span>\u00a0No obstant aix\u00f2,\u00a0despr\u00e9s de l’extirpaci\u00f3 del p\u00e0ncrees (parcial o\u00a0total<\/a>),<\/strong>\u00a0una o ambdues funcions es poden veure compromeses<\/strong><\/a>.<\/span><\/p>\n

<\/p>\n

Si el deteriorament d’una de les\u00a0funcions del p\u00e0ncrees<\/strong>\u00a0assoleix cert nivell, parlarem\u00a0d’insufici\u00e8ncia pancre\u00e0tica endocrina o exocrina.<\/strong><\/span>\u00a0Davant la pres\u00e8ncia d’una\u00a0insufici\u00e8ncia pancre\u00e0tica<\/strong>,\u00a0el pacient pot presentar manifestacions cl\u00edniques que afectaran de manera important la seva qualitat de vida.<\/span><\/p>\n

INSUFICI\u00c8NCIA PANCRE\u00c0TICA EXOCRINA<\/strong><\/span><\/h2>\n

La\u00a0insufici\u00e8ncia pancre\u00e0tica exocrina<\/strong>\u00a0es produeix quan la producci\u00f3 dels enzims digestius<\/strong>\u00a0(principalment\u00a0amilasa<\/em><\/a>\u00a0,\u00a0tripsina<\/em><\/a>\u00a0i\u00a0lipasa<\/em><\/a>\u00a0)\u00a0\u00e9s insuficient perqu\u00e8 el pacient pugui portar a terme una correcta digesti\u00f3\u00a0<\/strong>despr\u00e9s d’una ingesta aliment\u00e0ria normal.<\/span>\u00a0Aquests enzims tenen com a finalitat el convertir els greixos, prote\u00efnes i carbohidrats de la dieta en petites part\u00edcules que poden ser absorbides per l’intest\u00ed.<\/span>\u00a0Un pacient amb\u00a0insufici\u00e8ncia pancre\u00e0tica exocrina<\/strong>\u00a0presenta una deficient digesti\u00f3 dels aliments dins de l’intest\u00ed, circumst\u00e0ncia que pot provocar una simptomatologia variada.<\/span>\u00a0D’una banda, at\u00e8s que els enzims no han pogut preparar l’aliment per a l’absorci\u00f3 intestinal, aquesta es veu molt disminu\u00efda en comparaci\u00f3 amb la situaci\u00f3 normal.<\/span>\u00a0Com a conseq\u00fc\u00e8ncia, el pacient perd pes fins i tot portant a terme una\u00a0dieta hipercal\u00f2rica.<\/strong><\/span>\u00a0Aquesta p\u00e8rdua de pes condueix a una desnutrici\u00f3 que, si \u00e9s important, pot afectar en major o menor mesura a altres sistemes del cos i al sistema immunol\u00f2gic.<\/span>\u00a0D’altra banda, l’acumulaci\u00f3 d’aliment sense digerir en el tracte digestiu afavoreix el sobrecreixement bacteri\u00e0 i la pres\u00e8ncia de flatul\u00e8ncia important.<\/span>\u00a0Finalment, at\u00e8s que elements de la dieta com els greixos no s’han pogut absorbir correctament, el pacient presenta una diarrea caracter\u00edstica amb un alt contingut en greix que s’anomena esteatorrea.<\/span>\u00a0Afortunadament, avui dia disposem de complexos enzim\u00e0tics per al tractament de la\u00a0insufici\u00e8ncia pancre\u00e0tica exocrina.<\/strong><\/span>\u00a0Per a la m\u00e0xima efic\u00e0cia, aquest tractament s’ha de prendre durant els \u00e0pats i en ocasions han d’associar-f\u00e0rmacs que inhibeixen la producci\u00f3 d’\u00e0cid a l’est\u00f3mac per evitar la seva degradaci\u00f3 despr\u00e9s de la ingesta.<\/span><\/p>\n

INSUFICI\u00c8NCIA PANCRE\u00c0TICA ENDOCRINA<\/strong><\/span><\/h2>\n

METGES ESPECIALISTES I UN CORRECTE TRACTAMENT, MILLOR QUALITAT DE VIDA<\/strong><\/span><\/h2>\n

En els dos casos\u00a0d’insufici\u00e8ncia pancre\u00e0tica,<\/strong>\u00a0el tractament s’ha de dur a terme per metges especialistes (gastroenter\u00f2legs<\/a>\u00a0i\u00a0endocrin\u00f2legs<\/a>, respectivament), amb l’objectiu de reduir al m\u00e0xim les conseq\u00fc\u00e8ncies del\u00a0d\u00e8ficit de funci\u00f3 pancre\u00e0tica,<\/strong>\u00a0que pot comportar conseq\u00fc\u00e8ncies especialment a llarg termini.<\/span>\u00a0Diversos estudis han tractat la\u00a0qualitat de vida dels pacients amb la insufici\u00e8ncia pancre\u00e0tica despr\u00e9s d’una extirpaci\u00f3 quir\u00fargica del p\u00e0ncrees,<\/strong>\u00a0concloent que, encara que estigui seriosament afectada despr\u00e9s de la cirurgia, pot millorar de forma significativa i fins i tot equiparar-se a la de la poblaci\u00f3 general amb un correcte tractament.<\/span><\/p>\n

\n

\"dr-santiago-sanchez-cabus\"<\/h4>\n

“Diversos estudis han tractat la qualitat de vida dels pacients amb la insufici\u00e8ncia pancre\u00e0tica despr\u00e9s d’una extirpaci\u00f3 quir\u00fargica del p\u00e0ncrees, concloent que, encara que estigui seriosament afectada despr\u00e9s de la cirurgia, pot millorar de forma significativa i fins i tot equiparar-se a la de la poblaci\u00f3 general amb un correcte tractament “<\/strong><\/span><\/h4>\n

Dr.\u00a0Santiago S\u00e1nchez Cab\u00fas<\/a><\/p><\/blockquote>\n

\n

\"cita-sanchez-cabus-cirugia-del-pancreas\"<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

El\u00a0p\u00e0ncrees\u00a0presenta diverses funcions, entre les quals es troben: la\u00a0funci\u00f3 de control dels nivells de sucre en sang\u00a0(funci\u00f3 endocrina)\u00a0i la funci\u00f3 digestiva\u00a0(funci\u00f3 exocrina).\u00a0La\u00a0funci\u00f3 del p\u00e0ncrees\u00a0es reparteix de forma asim\u00e8trica al llarg de tota la gl\u00e0ndula;\u00a0aix\u00ed, al\u00a0cap del p\u00e0ncrees\u00a0predomina la funci\u00f3 exocrina,\u00a0mentre que al cos i la cua predomina la funci\u00f3 endocrina.\u00a0Aix\u00f2 no vol dir necess\u00e0riament que, […]<\/p>\n","protected":false},"author":2,"featured_media":181,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[44],"tags":[55,56,57],"yoast_head":"\nConseq\u00fc\u00e8ncies de l'extirpaci\u00f3 del p\u00e0ncrees: La insufici\u00e8ncia pancre\u00e0tica<\/title>\n<meta name=\"description\" content=\"Despr\u00e9s de l'extirpaci\u00f3 del p\u00e0ncrees (parcial o total), algunes de les funcions d'aquest organ es poden veure compromeses. 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Pel que fa a la\u00a0insufici\u00e8ncia pancre\u00e0tica endocrina,<\/strong>\u00a0aquesta es caracteritza per l’aparici\u00f3 d’una\u00a0diabetis despr\u00e9s de la intervenci\u00f3 quir\u00fargica.<\/strong><\/span>\u00a0En funci\u00f3 de la\u00a0p\u00e8rdua de teixit endocr\u00ed pancre\u00e0tic,<\/strong>\u00a0el pacient pot necessitar tractament amb antidiab\u00e8tics orals o fins i tot amb insulina subcut\u00e0nia.<\/span>\u00a0A m\u00e9s, els pacients als quals, per diferents circumst\u00e0ncies, se’ls ha hagut d’extirpar completament el p\u00e0ncrees<\/strong>\u00a0(pancreatectomia total)<\/strong><\/a>\u00a0, poden presentar un tipus especial de diabetis que es caracteritzar\u00e0 no solament per l’abs\u00e8ncia total d’insulina, sin\u00f3 tamb\u00e9 per l’abs\u00e8ncia d’altres hormones contrarreguladoras (per exemple, el\u00a0glucag\u00f3<\/em><\/a>).<\/span>\u00a0Aquest tipus de\u00a0diabetis<\/strong>\u00a0es caracteritza per ser de molt dif\u00edcil control i especialment per la pres\u00e8ncia de freq\u00fcents episodis de\u00a0hipoglic\u00e8mia<\/strong><\/a>\u00a0que, si no s\u00f3n detectats a temps pel pacient i els seus familiars, poden presentar serioses conseq\u00fc\u00e8ncies.<\/span><\/p>\n