Pancreas
Pancreatic resection is the removal of part or all of the pancreas. The pancreas is a glandular organ located behind the stomach which produces enzymes to aid digestion and hormones to help regulate blood sugar.
The pancreas is, therefore, part of the digestive tract and also part of the endocrine system. Since the functions of the pancreas are so complex and important, the goal of pancreatic resection is to remove all traces disease while preserving as much of the pancreas, bile duct and duodenum as possible.
Reasons For Pancreatic Resection
There are a number of reasons for removing all or part of the pancreas. Depending on the reason for the surgery and the location of the problem, the outcome of the surgery may vary a great deal. Some of the most common reasons for pancreatic resection are:
- Pancreatic cancer
- Severe or chronic pancreatitis
- Severe trauma
- Lymphoma
- Cancer of the bile duct or duodenum
- Severe hyperinsulinemic hypoglycemia
Diagnosing The Need For Pancreatic Resection
Several diagnostic tests may be done to determine the need for pancreatic resection and the predicted extent of the necessary surgical intervention. These may include:
- Pancreatic function test
- Glucose tolerance test
- Ultrasound
- CT Scan
- ERCP using contrast and X-rays
- Endoscopic exam and biopsy
The Pancreatic Resection Procedure
Pancreatic resection, depending on the nature of the problem, may be done laparoscopically or as an open procedure. When part of the duodenum has to be removed along with the pancreas, the surgery is called a pancreaticoduodenectomy. In some cases, particularly where there is advanced malignancy, the bile duct, duodenum and part of the stomach may also be removed in an operation called a Whipple procedure. This is a rare and technically difficult procedure in which the most experienced surgeons achieve the best outcomes.
Risks Of Pancreatic Resection
In addition to the risks common to any surgical procedure, a patient whose pancreas is removed will immediately become diabetic and be required to take insulin. The patient may also experience digestive problems for which digestive enzymes will be prescribed. Another possible risk is that there will be an anastomotic leak where the organs have been reattached. Surgeons watch the connection closely to prevent this from occurring. Otherwise, the risks of pancreatic resection are those common to all surgical procedures as follows:
- Excessive bleeding
- Blood clots
- Adverse reactions to anesthesia or medications
- Post-surgical infection
- Damage to adjacent organs
- Breathing problems
- Hernia at the incision site
- Anastomotic leak
Recovery From Pancreatic Resection
After pancreatic resection, the patient usually remains hospitalized for 2 to 3 weeks. For pancreatic cancer patients, either chemotherapy or radiation or both may begin or continued. The doctor will prescribe pain medication for post-surgical pain and there will be follow-up examinations necessary for removal of tubes and to monitor the patient’s recovery. As noted earlier, insulin and digestive enzymes will be prescribed as necessary.
