Understanding Pancreas conditions
Dr Peter Carr-Boyd is an experienced Hepatopancreatobiliary (HPB) surgeon and a currently practising adult and paediatric liver transplant surgeon, with expertise across the full spectrum of benign and malignant liver conditions.
This advanced specialist training ensures that liver surgery is performed safely, precisely, and to the highest international standards.
How the pancreas Supports Your Health
The pancreas is a vital organ with both endocrine and exocrine functions, playing a central role in digestion, metabolism, and overall health.
Exocrine function
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Produces digestive enzymes—including amylase, lipase, and proteases—that are powerful chemicals that break down carbohydrates, fats, and proteins, ensuring proper nutrient absorption. These chemicals are released into the pancreatic duct and then into the duodenum.
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Endocrine function
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The endocrine pancreas, located in the islets of Langerhans, regulates blood sugar levels by producing hormones such as insulin and glucagon, which control glucose storage and release. Together, these functions support energy production, nutrient utilization, and metabolic balance.
Dysfunction of the pancreas can lead to conditions such as pancreatitis, diabetes, pancreatic cysts, or pancreatic tumours, highlighting the importance of specialist evaluation and management of pancreatic lesions.
Pancreatic cysts
Pancreatic cysts are fluid-filled lesions that are often detected incidentally on imaging. While most are benign, certain worrisome features—such as increasing size, thickened or irregular walls, solid components, or dilation of the pancreatic duct—may suggest a higher risk of cancer and require further evaluation.
Pancreatic Cancer
Pancreatic adenocarcinoma
Pancreatic adenocarcinoma is the most common and aggressive form of pancreatic cancer. It typically arises in the exocrine pancreas, and early stages may be asymptomatic. When symptoms occur, they often include abdominal pain, jaundice, unexplained weight loss, poor appetite, and digestive difficulties. Due to its aggressive nature, early detection and prompt surgical evaluation are essential. Management may involve surgical resection, chemotherapy, and multidisciplinary care.
Pancreatic neuroendocrine tumours (NETs) arise from the endocrine cells of the pancreas. They can be functioning—producing hormones such as insulin, gastrin, glucagon, or vasoactive intestinal peptide—or non-functioning, which do not produce detectable hormones. Functioning NETs often cause specific symptoms like low blood sugar (insulinoma), peptic ulcers (gastrinoma), or flushing and diarrhea (VIPoma), while non-functioning NETs are often discovered incidentally during imaging for other reasons. The behaviour and treatment of NETs vary depending on their grade and size. Low-grade (well-differentiated) NETs tend to grow slowly and may be managed with surgical resection, surveillance, or targeted therapy depending on tumour location, size, and hormone activity. High-grade or poorly differentiated NETs are more aggressive, may spread (metastasize) early, and often require a combination of systemic therapies and multidisciplinary care. Evaluation typically includes CT, MRI, endoscopic ultrasound (EUS), hormone testing, and often functional imaging such as Ga-68 DOTATATE PET/CT and FDG PET/CT which helps assess the extent of disease and hormone activity.
Pancreatic neuroendocrine tumours
solid Pseudo-papillary tumours
Solid pseudopapillary tumours (SPTs) are rare pancreatic tumours that usually affect younger adults, especially women. They are generally slow-growing and often discovered incidentally or during investigation of vague abdominal discomfort. While most SPTs are considered low-grade malignancies, surgical removal is recommended due to the risk of local invasion. Outcomes after surgery are typically excellent.
Other pancreatic masses
Other pancreatic masses include benign tumours, inflammatory pseudotumours, acinar cell tumours or metastatic lesions from cancers elsewhere in the body. The clinical approach depends on the type, size, location, and symptoms of the mass. Imaging with CT, MRI, or endoscopic ultrasound (EUS), sometimes combined with biopsy, helps determine the appropriate course of action. A specialist pancreatic surgeon like Dr Peter Carr-Boyd ensures that each patient receives personalized, evidence-based care, whether this involves surgical removal, surveillance, or multidisciplinary treatment, optimizing both safety and long-term outcomes.