(Central Pancreatectomy; Distal Pancreatectomy; Total Pancreatectomy)
DefinitionThe pancreas is a long, flat, pear-shaped organ located behind the stomach. It makes digestive enzymes and hormones, including insulin.
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- Part of the stomach or small intestine
- Nearby lymph nodes
Reasons for ProcedureThis procedure is done to treat certain health conditions, such as pancreatic cancer or pancreatic necrosis due to pancreatitis .
Possible ComplicationsProblems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Leakage of pancreatic enzymes into the abdomen
- Damage to other organs in the abdomen
- Chronic disease such as diabetes or obesity
- Poor nutrition
- Malabsorption problems
What to Expect
Prior to ProcedureYou 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 or area of necrosis
AnesthesiaGeneral anesthesia will be used. You will be asleep through the surgery.
Description of the ProcedureAn incision will be made in the abdomen. The affected part of the pancreas, as well as other affected areas, will be removed. The incision will be closed 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.
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?Anesthesia will block pain during the procedure. You will have pain after the procedure. Ask your doctor about medication to help manage pain.
Average Hospital StayYou may need to stay in the hospital from 5 days to 3 weeks. This depends on the extent of your surgery. If you have any problems, you will need to stay longer.
Post-procedure CareAt the HospitalRight after the procedure, you will be in a recovery room where your blood pressure, pulse, and breathing will be monitored. Recovery may also include:
- Pain medications
- Antibiotics to prevent infection
- Medication to prevent blood clots
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
- 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 recommend a special diet, supplements, or other medications.
- Be sure to follow your doctor's instructions.
Call Your DoctorCall your doctor if any of these occur:
- Signs of infection, such as fever or chills
- Redness, swelling, increasing pain, bleeding, or discharge from the incision
- Pain that you can't control with the medications you've been given
- Persistent nausea or vomiting
- New or worsening diarrhea—this may indicate you are not digesting enzymes properly
- Extreme thirst
- Frequent urination
- Difficulty controlling urination
- Increased urination at night
- Extreme hunger
- New or worsening fatigue
- Blurred vision
- Numbness or tingling in hands or feet
- Sores that heal slowly, especially in the legs or feet
National Cancer Institute
Pancreatic Cancer Action Network
Canadian Cancer Society
Pancreatic Cancer Canada
Allendorf J. Surgical options. The Pancreas Center. Columbia University Medical Center website. Available at: http://www.columbiasurgery.org/media/lectures/pancreas%5Fawareness%5F20101113.pdf. Published November 13, 2010. Accessed December 9, 2014.
Pancreatic cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003131-pdf.pdf. Updated June 11, 2014. Accessed December 9, 2014.
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 December 9, 2014.
Pancreatic cancer. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated December 4, 2014. Accessed December 9, 2014.
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 December 9, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014
- Update Date: 12/20/2014