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Pancreas Resection Surgery

Pancreatic resection is a surgical procedure that involves the removal of a part of the pancreas. This surgery is typically performed to treat a tumor and may include removing the body and tail of the pancreas. In some cases, the spleen may also be removed.

Reasons for Pancreatic Resection:

  • Pancreatic Carcinoma
  • Pancreatic Endocrine Tumors (e.g., Insulinoma): These rare tumors begin in the endocrine cells of the pancreas that produce insulin.
  • Pancreatic Cysts: Fluid-filled sacs on or inside the pancreas. Most are non-cancerous, but cancerous cysts may require surgical removal.
  • Chronic Pancreatitis: A progressive inflammation of the pancreas that leads to irreversible damage and symptoms such as abdominal pain, malabsorption, and diabetes mellitus.
  • Periampullary Carcinoma: Occurs near the pancreatic duct insertion at the ampulla of Vater.

Alternate Names:

  • Whipple Pancreaticoduodenectomy (removal of the pancreatic head, second part of the duodenum, and bile duct)
  • Distal Pancreatectomy (removal of the body and tail of the pancreas, typically for tumors located in these areas)

Location of Surgery:

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

Pancreatic Resection Procedure Type:

Surgical procedure

Preparation for Pancreatic Resection Surgery:

Before undergoing pancreatic resection, several tests may be required, including:

  • Imaging tests: Ultrasonography, X-rays, and CT scans help detect suspicious areas, assess the spread of cancer, and monitor treatment effectiveness.
  • Endoscopic Retrograde Cholangiopancreatography (ERCP): Used to visualize ducts that carry bile and for stenting if necessary.
  • Angiography: To assess blood supply to the pancreas.
  • Needle Aspiration: To check for cancer cells.
  • Whole Body PET-CT: To rule out metastasis.

Your doctor may also recommend chemotherapy for borderline resectable tumors, pre-operative medications to reduce infection risk, and bowel preparation. It’s essential to discuss the type of surgery, recovery time, risks, and anesthesia with your healthcare provider.

Pancreatic Resection Surgery Procedure:

On the day of surgery, you’ll need to fast for at least 10 to 12 hours before the procedure. An anesthesiologist will administer anesthesia via an IV to keep you asleep during the surgery. The surgeon may use open surgery for full access to the pancreas and surrounding organs, although laparoscopic or robotic surgery may be used in some cases for quicker recovery. Robotic surgery provides the most precise results and the quickest recovery time.

Recovery After Pancreatic Resection Surgery:

Recovery typically takes 4 to 8 weeks, depending on the type of surgery (open or laparoscopic) and your overall health. You’ll need to take time off from work to rest and heal, and light walking is encouraged to improve circulation and build strength. Avoid heavy lifting or strenuous exercise until fully recovered.

Follow-Up After Pancreatic Resection Surgery:

Pancreatic resection is a major surgery, and your hospital stay may last from one to three weeks, depending on your recovery. After surgery, you may need chemotherapy or a combination of chemotherapy and radiation therapy to improve survival rates, but these treatments are only started once you have fully recovered.

Post-surgery, you may experience abdominal pain and discomfort, which can be managed with pain medications. Regular follow-up visits are necessary to monitor your recovery. If you undergo complete pancreatic resection, you will require pancreatic enzyme replacement therapy and possibly insulin injections for proper digestion.

Risks Associated with Pancreatic Resection Surgery:

Pancreatic resection carries several risks, with studies showing that approximately 41% of cases have some form of complication. Common risks include:

  • Postoperative bleeding
  • Delayed gastric emptying (slow digestion of food and liquids)
  • Pancreatic anastomotic leak
  • Pancreatic insufficiency
  • Surgical site infections
  • Urinary tract or chest infections
  • Scarring or adhesions
  • Hernia

It’s crucial to discuss the potential risks with your doctor to make an informed decision about undergoing pancreatic resection.

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