Pancreatectomy and Total Pancreatectomy
Most pancreatectomy procedures are performed to treat pancreatic tumours or cancers. There are a select group of patients with chronic inflammation of the pancreas who may benefit from total pancreatectomy to relieve their chronic abdominal pain
Pancreatectomy is a potentially curative option in the treatment of pancreatic cancer. With this procedure, the pancreas is partially or entirely removed. Total pancreatectomy surgery includes removal of not only the pancreas but also parts of other organs, including stomach, gall bladder, intestine, spleen, the biliary duct and some lymph nodes. On the other hand, partial pancreatectomy refers to the removal of certain parts of the pancreas such as tail (distal pancreatectomy), head (Whipple procedure), or body (median pancreatectomy).
Prognosis following pancreatectomy
Pancreatectomy is a major surgery, associated with significant morbidity/complication ranging from 30-60% chance even in the best surgical centres in the world. Distal pancreatectomy is associated with 1-3% mortality, while Whipple procedure is associated with 3-5% mortality. The important considerations are that the decision for pancreatectomy is well-discussed and risks/benefits are well explained. Such operations have better outcomes with high volume pancreatic centres or surgeons. Despite the surgical risks, pancreatectomy remains the only potentially curative option for patients with pancreatic cancer
Complications of Pancreatectomy Surgery
Pancreatectomy surgery is done to remove cancerous pancreatic tissue, but it can result in mild to severe complications, which can lead to death.
The complications resulting from pancreatectomy surgery depend on which part or which tissues of the pancreas are removed. Such complications can include the following:
Hemorrhage or Bleeding
Postoperative bleeding can occur following pancreatectomy surgery. This is more common with Whipple procedure than distal pancreatectomy. Some patients may require re-operation to resolve postoperative bleeding.
This can occur with either the Whipple procedure or distal pancreatectomy. Pancreatic fistula occurs when pancreatic tissue heals poorly after surgery, resulting in leakage of pancreatic fluid into the abdomen. If the fistula is uncontrolled, it can lead to shock and organ failure. Majority of pancreatic fistula will heal over time, usually over several weeks.
In addition, the entire removal of the pancreas can causes digestive and endocrine disorders such as difficulty in digestion, weight loss, diarrhoea (loose stools) and diabetes. Doctors will usually prescribe medication post-pancreatectomy procedure in the event of these symptoms
As the pancreas is responsible for the secretion of some digestive enzymes, surgery of the pancreas may be associated with leakage of enzymatic juice, causing digestion or injury of other surrounding tissues and organs
Do discuss pancreatic surgery or pancreatic conditions with your doctor. Better outcomes after pancreatic surgery is associated with high volume pancreatic centres and dedicated pancreatic surgeons