A pancreatectomy is the surgical removal of all or part of the pancreas.
There are several types of pancreatectomy including pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy, the removal of the entire pancreas.
Pancreas surgery is used to treat a number of conditions involving the pancreas including:
Partial pancreatectomy – If the pancreatectomy is partial, the surgeon clamps and cuts the blood vessels, and the pancreas is stapled and divided for removal. If the disease affects the splenic artery or vein, the spleen is also removed.
Total pancreatectomy – If the pancreatectomy is total, the surgeon removes the entire pancreas and attached organs. He or she starts by dividing and detaching the end of the stomach. This part of the stomach leads to the small intestine, where the pancreas and bile duct both attach. In the next step, he removes the pancreas along with the connected section of the small intestine. The common bile duct and the gallbladder are also removed. To reconnect the intestinal tract, the stomach and the bile duct are then connected to the small intestine.
During a pancreatectomy procedure, several tubes called drains are also inserted for postoperative care. To prevent tissue fluid from accumulating in the operated site, a temporary drain leading out of the body is inserted, as well as a gastrostomy or g-tube leading out of the stomach in order to help prevent nausea and vomiting. A jejunostomy or j-tube may also be inserted into the small intestine as a pathway for supplementary feeding.
A total pancreatectomy is a surgical procedure performed to treat chronic pancreatitis when other treatment methods are unsuccessful. This procedure involves the removal of the entire pancreas, as well as the gallbladder, common bile duct, and portions of the small intestine and stomach, and most often, the spleen.
Total pancreatectomy can be combined with transplantation of the patient’s own insulin-producing cells in order to keep the patients from becoming diabetic. A total pancreatectomy without this islet cell transplant results in 100% certainty that the patient will need insulin for life.
Common advantages are:
It depends on the type of surgery that is being performed.
Most patients have a bladder catheter which is usually left until the epidural pain catheter is removed, between day five and seven after surgery. Also, you will have at least one drainage tube coming from inside your abdomen. This is usually placed next to where your pancreas is reattached to your bowel (Whipple) or transected (distal pancreatectomy). This drain is most often removed before you are discharged from the hospital. Occasionally, if you have a small bile duct, you will have another tube placed in your bile duct that will be taken out two months after surgery.
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