The pancreas is a little-known organ – and yet essential for our body. It plays a crucial role in the digestion of food and the production of insulin. Where is he ? What are its exact functions? What illnesses can he suffer from? And how to detect them? We take stock.

The pancreas is part of the digestive system and the endocrine system. It is the second largest gland in our body – behind the liver: it weighs about 70 grams and measures on average 15 centimeters long by 4 centimeters wide and 2 centimeters thick.

The pancreas is very deeply installed in our abdomen, behind our stomach, between the small intestine and the spleen. It crosses almost the entire abdomen from left to right and passes in front of the spine. Specifically, it takes the form of a flat, elongated pouch that extends transversely from the duodenum (the first segment of the small intestine) to the spleen.

It is generally broken down into three parts: the head (encircled by the duodenum), body and tail (which affects the spleen). It is sometimes given a fourth part: the neck, or isthmus (which is between the head and the body).

The pancreas is a “mixed gland”because it has two functions:

• an exocrine function, which allows the secretion of juices in the duodenum;
• an endocrine functionwhich helps secrete hormones into the bloodstream.

We are therefore talking about amphicrine gland (which combines exocrine and endocrine functions).

The pancreas produces pancreatic juices through its specialized cells, the acini. These juices contain many enzymes useful for digestion. As stated above, they are dumped into the duodenum to allow digestion of fats and sugars. Note: each pancreatic juice has a well-defined role:

• amylases deal with sugars (starches, polysaccharides, etc.);
• lipases cut lipids (triglycerides, diglycerides and monoglycerides);
• proteases take over proteins.

The pancreas also has the function of producing (and dumping) various hormones into the blood thanks to other specialized cells, concentrated in the islets of Langerhans. Each participates in its own way in the regulation of blood sugar (and thus avoids complications such as diabetes):

• insulin (hypoglycemic hormone), which lowers the level of sugar (glucose) in the blood by moving the sugar to the cells;
• glucagon (hyperglycemic hormone), which increases blood sugar levels by stimulating the liver to release its reserves;
• and somatostatin (“Swiss Army Knife” hormone), capable of inhibiting the secretion of the above hormones.

The pathologies associated with the pancreas are numerous:

Whether acute (sudden) or chronic (developed over a long period), pancreatitis refers to inflammation of the pancreas. In the vast majority of cases, it is linked to excessive and repeated consumption of alcohol. But several other causes may be involved: a dysfunction of biliary origin, an autoimmune disease, a genetic disease, and more rarely tumours.

Treatment for pancreatitis depends on the cause of the inflammation and may include painkillers to relieve pain, antibiotics to fight infection, and in some cases surgery to remove gallstones or tumors.

Pancreatic cancer is rare, but aggressive. It mainly affects people with diabetes and / or prone to pancreatitis. We distinguish exocrine pancreatic cancers (which develop in cells that produce digestive enzymes) and endocrine pancreatic cancers (which develop in cells that produce hormones).

The main risk factors are alcohol, tobacco and a diet too rich in animal fats.

Once declared, the treatment of pancreatic cancer depends on the stage of the disease. It may require surgery, which allows doctors to extract the tumour. Sessions of radiotherapy or chemotherapy can be associated with it to stop the progression of the cancer (when the two treatments are associated, we speak of radiochemotherapy).

Type 1 diabetes is a form of diabetes that involves the pancreas does not produce enough insulin. It is often diagnosed in children and adolescents, although cases can also occur in adults. As a reminder, the exact cause of type 1 diabetes is still unknown, but it seems that the disease is linked to genetic and environmental factors. The treatment, meanwhile, generally involves insulin injections and the adoption of strict lifestyle and dietary measures (a balanced diet, regular physical exercise, good sleep hygiene, etc.).

Some people born with what is called a pancreas divisum (divided pancreas), a birth defect of the pancreas that results from the lack of fusion between the dorsal and vental ducts of the pancreas. In some cases, this situation leads to complications such as problems with digestion or blood sugar regulation.

Diseases of the pancreas, such as type 1 diabetes or pancreatitis, alter the functioning of this organ, which generally leads to digestive disorders and problems with blood sugar regulation. In details :

• Acute pancreatitis is manifested by severe abdominal painof the nausea and vomiting.
• Symptoms of chronic pancreatitis may include abdominal pain, weightlossdigestive problems and yellowing of the skin.
• Pancreatic cancers can also cause abdominal pain, nausea, vomiting, weight loss and yellowing of the skin.
• Symptoms of type 1 diabetes include excessive thirsta fatiguea frequent urge to urinaterapid weight loss and loss of sight.
• Finally, an anomaly such as the pancreas divisum causes abdominal pain and increases the risk of acute pancreatitis.

If you notice any of these symptoms, so don’t wait to see your doctor!

Patients usually start by seeing their GP, who quickly switches over (when possible) to a gastroenterologist. Several tests can diagnose damage to the pancreas, including blood tests:

• A blood test for carcinoembryonic antigen (ACE), a protein found in the intestine, liver and pancreas. This assay is not a specific tumor factor, but it can guide the diagnostic workup. “Normal” values ​​should be less than 5 micrograms/L.
• A blood test for carbohydrate antigen 19-9, a protein found in small amounts on the surface of some cancer cells. This assay is prescribed for the diagnosis and monitoring of pancreatic cancer. The “normal” concentration should be less than 37 U/ml.

Other exams, such as ultrasoundaendoscopic retrograde colangiopancreatography (ERCP), a to scanan Ihepatic MR or a biopsy may also be recommended to refine the diagnosis.

As surprising as it may seem, yes, we can live without a pancreas, provided we carefully follow insulin treatment (injected through the skin) and pancreatic enzymes (orally). Life without a pancreas, however, can be difficult and lead to other long-term health complications.