• Pancreatectomy

    (Central Pancreatectomy; Distal Pancreatectomy; Total Pancreatectomy)

    Definition

    The pancreas is an important structure in your abdomen that makes enzymes. One type of enzyme helps aid in food digestion. Another type helps regulate sugar levels in the blood.
    The Pancreas
    IMAGE
    Copyright © Nucleus Medical Media, Inc.
    This is surgery to remove the pancreas. In this procedure, all or part of the pancreas can be removed. In some cases, other nearby structures may also be removed, such as:
    • Gallbladder
    • Spleen
    • Part of the stomach or small intestine
    • Nearby lymph nodes

    Reasons for Procedure

    This procedure is most often done to treat pancreatic cancer .

    Possible Complications

    If you are planning to have a pancreatectomy, your doctor will review a list of possible complications, such as:
    • Leakage of pancreatic enzymes into the abdomen
    • Damage to other organs in the abdomen
    Factors that may increase the risk of complications include:
    • Obesity
    • Increased age
    • Smoking
    • Poor nutrition
    • Respiratory or cardiac disease
    The pancreas produces many necessary digestive enzymes and helps regulate blood sugar. When part of the pancreas is removed, long-term complications may result, such as:
    • Diabetes
    • Malabsorption problems
    Discuss these risks with your doctor before surgery.

    What to Expect

    Prior to Procedure

    You may need to have chemotherapy or radiation therapy to reduce the size of a tumor before surgery.
    Leading up to the procedure, your doctor may do the following:
    • Physical exam
    • Blood tests
    • Imaging studies to better locate the cancer
    Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Aspirin and other nonsteroidal anti-inflammatory drugs, such as ibuprofen and naproxen
    • Blood-thinning drugs
    • Anti-platelet drugs
    You should arrange for a ride to and from the hospital.

    Anesthesia

    General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV.

    Description of the Procedure

    The doctor will make an incision in the abdomen. The affected part of the pancreas, as well as other affected areas, will be removed. The doctor will close the incision with stitches or staples.
    Tubes may be placed that come out of the abdomen. A tube will drain fluid from the surgery site. Another tube may run from the intestines and out of the abdomen to give you nutrition.
    If only a part of the pancreas needs to be removed, your doctor may do the surgery laparoscopically. Small incisions will be made and a camera will be inserted. This will help the doctor see inside the abdomen to remove the affected part of the pancreas.

    Immediately After Procedure

    You will be taken to the recovery room. While you are there, your breathing tube may be removed.

    How Long Will It Take?

    The surgery can take 4-8 hours, depending on what part or how much of the pancreas is removed.

    How Much Will It Hurt?

    Pain or soreness during recovery will be managed with pain medicine.

    Average Hospital Stay

    You may need to stay in the hospital from five days to three weeks. This depends on the extent of your surgery. If you have any problems, you will need to stay longer.

    Post-procedure Care

    At the Hospital
    At the hospital, the staff will:
    • Monitor you for any problems
    • Give you medicines for pain and nausea
    • Remove the tubes as you recover and heal
    At Home
    When you return home, do the following to help ensure a smooth recovery:
      Depending on how much of your pancreas was taken, it may not make adequate amounts of enzymes for your body. If this is the case, your doctor may give you special instructions, such as:
      • Eat a special diet.
      • Take enzyme supplements to help digest food.
      • Take insulin to help regulate blood sugar levels.
    • Ask your doctor about when it is safe to shower, bathe, or soak in water.
    • Return to light activity when you feel comfortable. Do not do any heavy lifting or straining for 6-8 weeks.
    • Recovery after this surgery may take many months. It may be difficult to adjust if you had to start taking new medicines or change your diet. Consider talking to a therapist or joining a support group to discuss your feelings.
    • Follow your doctor’s instructions.

    Call Your Doctor

    After you leave the hospital, contact your doctor if any of the following occurs:
    • Signs of infection, such as fever or chills
    • Redness, swelling, increasing pain, bleeding, or discharge from the incision
    • Nausea and/or vomiting
    • Pain that you are unable to control with the medicines you have been given
    • Any new concerns
    In case of an emergency, call for medical help right away.

    RESOURCES

    National Cancer Institute http://www.cancer.gov

    Pancreatic Cancer Action Network http://www.pancan.org

    CANADIAN RESOURCES

    Canadian Cancer Society http://www.cancer.ca

    Pancreatic Cancer Canada http://www.pancreaticcancercanada.ca

    References

    Allendorf J. Surgical options. The Pancreas Center. Columbia University Medical Center website. Available at: http://www.columbiasurgery.org/media/lectures/pancreas%5Fawareness%5F20101113.pdf . Updated November 2010. Accessed April 2, 2013.

    Pancreatic cancer. American Cancer Society website. Available at: http://www.cancer.org/cancer/pancreaticcancer/index . Accessed April 2, 2013.

    Learn about pancreatic cancer: surgery. Pancreatic Cancer Action Network website. Available at: http://www.pancan.org/section%5Ffacing%5Fpancreatic%5Fcancer/learn%5Fabout%5Fpan%5Fcancer/treatment/surgery/ . Accessed April 2, 2013.

    Pancreatectomy. University of California, San Francisco website. Available at: http://surgery.ucsf.edu/conditions--procedures/pancreatectomy.aspx. Accessed April 2, 2013.

    Disease information. Baylor College of Medicine website. Available at: http://www.bcm.edu/pancreascenter/index.cfm?pmid=9291 . Updated March 15, 2013. Accessed April 2, 2013.

    Pancreatic cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated March 26, 2013. Accessed April 2, 2013.

    Surgical techniques for pancreas preservation. Center for Pancreatic and Biliary Diseases, University of Southern California website. Available at: http://www.surgery.usc.edu/divisions/tumor/pancreasdiseases/web%20pages/pancreas%20resection/ORGAN%20PRESERVATION.html. Accessed April 2, 2013.

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