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Pancreatic Surgery

Pancreatic surgery involves the removal of part or all of the pancreas, depending on the patient’s medical condition.

Alternate Names for Pancreatic Surgery:

  • Pancreatectomy
  • Pancreaticoduodenectomy (Whipple procedure)

Location of the Pancreas:

The pancreas is located behind the stomach and in front of the spine, within the abdomen.

Conditions Treated with Pancreatic Surgery:

Pancreatic surgery is recommended for various disorders affecting the pancreas and surrounding tissues, including:

  • Pancreatic cysts
  • Pancreatitis
  • Primary pancreatic cancer
  • Metastatic pancreatic cancer
  • Neuroendocrine cancer of the pancreas
  • Ampullary cancer
  • Bile duct cancer
  • Duodenal cancer

When Is Pancreatic Surgery Recommended?

A gastroenterologist may suggest pancreatic surgery for the following conditions:

  • Pancreatic carcinoma
  • Pancreatic cysts
  • Pancreatic tumors
  • Ampullary cancer
  • Pancreatitis
  • Bile duct cancer
  • Neuroendocrine tumors
  • Small intestine cancer
  • Pancreatic or small intestine injury
  • Other tumors or diseases of the bile duct, duodenum, or pancreas

Types of Pancreatic Surgery:

Pancreatic surgery can be performed using open surgery, laparoscopic surgery, or robotic surgery. The main types of procedures include:

  • Staging Laparoscopy: A minimally invasive procedure using a laparoscope to examine the abdomen through small incisions.
  • Potentially Curative Surgery: When imaging and test results indicate that the cancer can be completely removed.
  • Whipple Procedure (Pancreaticoduodenectomy): Removal of the pancreas head, the first section of the small intestine, gallbladder, and bile duct.
  • Distal Pancreatectomy: Removal of the body or tail of the pancreas to treat tumors or cancer in that region.
  • Total Pancreatectomy: Complete removal of the pancreas, often used to treat chronic pancreatitis when other treatments have failed.
  • Bypass Surgery: Used to redirect bile flow from the common bile duct directly into the duodenum or small intestine, bypassing the pancreas.
  • Palliative Surgery: A procedure aimed at alleviating symptoms (e.g., a nerve block for pain or stent implantation to relieve blockage) but not directly targeting cancer.

Preparation for Pancreatic Surgery:

Before undergoing pancreatic surgery, your doctor will discuss the process with you in detail. You may be instructed to:

  • Take prescribed medications before surgery
  • Avoid alcohol for 24 hours before surgery
  • Avoid tobacco use before surgery

Pancreatic Surgery Procedure:

Before surgery, your doctor will check vital signs, blood sugar, and blood pressure to ensure everything is within normal ranges. The surgery may be performed laparoscopically through small incisions or as an open surgery with a larger abdominal incision. Once the surgery is completed, the incisions are closed, and antiseptic dressings are applied to prevent infection.

Risks of Pancreatic Surgery:

Although it is a common procedure, pancreatic surgery carries some risks, including:

  • Leakage: Fluid leakage from the pancreas or bile ducts
  • Bleeding: Bleeding at the incision site
  • Infection: Infection in the abdomen or around the incision
  • Diabetes: If the entire pancreas is removed, permanent diabetes may develop
  • Weight Loss: Due to poor absorption of fat and vitamins after surgery

Recovery After Pancreatic Surgery:

After surgery, pain relievers or injections will be administered to keep you comfortable. Your vital signs will be monitored, and if needed, blood or glucose may be transfused. Physiotherapy may begin during your hospital stay to help maintain your physical health. You may also practice yoga or meditation as part of your recovery routine.

Once your condition improves, you may be allowed to return home, but you will need to follow a prescribed diet and take medications as recommended. A nutritious diet is crucial for aiding recovery, as it helps your body tolerate medications and rebuild strength.

Follow-up After Pancreatic Surgery:

Follow-up visits are essential for monitoring recovery and ensuring that you are healing well. Additional tests may be conducted to check on your progress. Some individuals, especially older patients or those with pre-existing health conditions, may need temporary admission to a recovery center. After 4 to 6 weeks, most patients can return to normal activities, though recovery times vary based on individual health and the complexity of the surgery.

For pancreatic cancer survivors who have had a total pancreatectomy, diabetes may develop. These individuals will need to manage their condition with diabetic medications and adjust their diet accordingly for the rest of their lives.

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