Everything You Need to Know About Pancreatic Surgery

For a pancreatic cancer patient, assessing types of pancreatic surgery is important. Up to 20 percent of patients could qualify for surgery, providing a potential cure for many.

Pancreatic surgery, while crucial for treating various conditions, can lead to complications such as pancreatic fistula, bleeding, infection, and delayed gastric emptying (undigested food remaining in the stomach).

To understand treatment options for pancreatic disorders, or support your loved ones undergoing surgery, understanding the different types of surgery is important.

So, here’s everything you need to know about pancreatic surgeries.

What are the types of pancreatic surgery?

Pancreatic surgery involves various procedures aimed at treating different conditions related to the pancreas. Here are some of the different types of pancreatic surgery:

1. Central pancreatectomy

Central Pancreatectomy is a surgical procedure involving the removal of the middle portion of the pancreas. It is often used to treat tumors or lesions located in the central region of the pancreas while preserving the surrounding healthy tissue. This procedure aims to minimize the risk of postoperative diabetes and exocrine insufficiency associated with traditional pancreatectomy procedures.

This procedure may be particularly suitable for patients with small pancreatic ductal adenocarcinoma (PDAC) at the neck of the pancreas. Although not frequently performed, central pancreatectomy appears to be an oncologically safe surgical option for selected patients, with a higher postoperative morbidity rate compared to other radical procedures for pancreatic lesions.

2. Total Pancreatectomy

It is a surgical procedure involving the complete removal of the pancreas. It is typically performed to treat severe cases of chronic pancreatitis, pancreatic cancer, or other conditions affecting the entire pancreas. After this procedure, patients require lifelong insulin and enzyme replacement therapy to manage diabetes and digestive issues.

The indications for total pancreatectomy include cases where a life-threatening hemorrhage and sepsis can occur due to pancreatic fistula, and in cases of recurrence. It has been used to treat both benign and malignant diseases of the pancreas, although its use has been limited by concerns about the management of long-term complications, including diabetes.

If you are undergoing total pancreatectomy, you may experience long-term complications, including the onset of diabetes in all cases, except when successful islet cell transplantation ( islet cells are cells in the pancreas for hormone production) is performed.

Additionally, delayed gastric emptying (food is sitting for too long in the stomach) is a common condition that often resolves itself over time.

Total pancreatectomy and islet autotransplantation can also be considered for chronic pancreatitis when other therapies fail. Islet autotransplantation has the potential to relieve pain and preserve beta-cell mass in patients.

3. Robotic Distal Pancreatectomy

Robotic distal pancreatectomy (RDP) is a surgical procedure that involves using a robotic surgical system to remove the distal (tail) portion of the pancreas. Studies have shown comparable outcomes to traditional laparoscopic procedures, with potential benefits such as improved spleen preservation.

RDP involves the use of a robotic surgical system. It is considered a safe and feasible option for selective distal pancreatic lesions, with perioperative outcome profiles comparable to laparoscopic and open distal pancreatectomies.

There is some discussion about the cost-effectiveness of RDP compared to open and laparoscopic distal pancreatectomies. Although the total cost may be a little bit on the higher side, robotic distal pancreatectomies are much safer as compared to open and laparoscopic procedures.

4. Whipple Procedure

The Whipple procedure, also known as pancreaticoduodenectomy, is a complex surgical operation primarily used to treat tumors and conditions in the pancreas, small intestine, and bile ducts. It involves the removal and reconstruction of the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder, and the bile duct:

The Whipple procedure is often used to treat pancreatic cancer that hasn’t spread beyond the pancreas.

Only about 20% of pancreatic cancer patients are eligible for the Whipple procedure and other surgeries. These are usually patients whose tumors are confined to the head of the pancreas and haven’t spread into any nearby major blood vessels, the liver, lungs, or abdominal cavity.

The Whipple procedure is a complex operation and can have serious risks. However, it is often considered a life-saving surgery.

You may undergo outpatient chemotherapy before or after surgery, or both, depending on the type and stage of the tumor.

Chemotherapy, radiation therapy, or clinical trials are alternatives to the Whipple procedure, depending on the specific situation.

The recovery period after the Whipple procedure can vary, and patients typically stay in the hospital for one to two weeks following the surgery.

What is the Role of MedicoExperts in treating pancreatitis and pancreatic cancer?

MedicoExperts play a significant role in treating pancreatitis and pancreatic cancer by employing a tumor board approach, where highly skilled medical, surgical, and radiation oncologists collaborate closely to achieve the best possible treatment outcome.

This approach aims to improve survival rates in pancreatic cancer patients and offers a new way to ensure successful outcomes.

Additionally, MedicoExperts, as a global virtual hospital, provides quality healthcare services to patients worldwide, ensuring access to the best possible treatment. This multidisciplinary approach and global accessibility contribute to enhancing the overall care for individuals with pancreatitis and pancreatic cancer.

Conclusion

Pancreatic surgery consists of various types, including the Whipple procedure (pancreaticoduodenectomy) for tumors in the head of the pancreas, distal pancreatectomy for tumors in the body or tail, and total pancreatectomy for extensive disease.

These surgeries aim to remove cancerous or diseased tissue, offering potential curative benefits. However, pancreatic cancers are often diagnosed at advanced stages, limiting the effectiveness of surgery as the sole treatment.

Therefore, a multidisciplinary approach involving surgery, chemotherapy, and radiation therapy is crucial for managing pancreatic cancer. Additionally, you can have better outcomes and survival because of advancements in surgical techniques like robotic procedures.

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References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229532/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035443/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3866069/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231987/