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Pancreatectomy, Open or Laparoscopic Surgery


Why is this procedure done?


Pancreatectomy is done to remove the whole pancreas or parts of the pancreas. The pancreas is an organ that makes and releases juices that help break down food. It uses hormones called glucagon and insulin to control the sugar levels in your blood. ‚  
Types of pancreatectomy: ‚  
  • Whipple procedure ¢ ˆ ’ The doctor removes the gallbladder, part of the stomach, parts of the pancreas, the small bowel, and the bile duct. Your doctor will leave enough of the pancreas to make juices for digestion and insulin.
  • Total pancreatectomy ¢ ˆ ’ The doctor removes the whole pancreas, only part of the stomach, the small bowel, the common bile duct, gallbladder, spleen, and nearby lymph nodes.
  • Distal pancreatectomy ¢ ˆ ’ The doctor removes the body and tail of your pancreas and the spleen.

Pancreatectomy is done to treat: ‚  
  • Pancreatic cancer
  • Cancer of the stomach or large bowel that has moved into the pancreatic tail
  • Cancer of the bile duct and pancreatic duct
  • Pancreatitis or inflamed pancreas
  • Injury to the pancreas
  • Growth of the pancreas
  • Abnormal tumors that grow and can make hormones such as insulin. These are hormone-secreting tumors.


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What will the results be?


The surgery will remove the diseased part or the pancreas. It may stop the spread of cancer cells to other parts of the body or remove those cells that have already spread. ‚  

What happens before the procedure?


  • Your doctor will take your history. Talk to your doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • When you need to stop eating or drinking before your procedure.
  • Your doctor will do an exam and may order:
    • Lab tests
    • X-rays
    • Angiography
    • Ultrasound
    • CT or MRI scan
    • Endoscopic retrograde cholangiopancreatography
  • The surgery is done as an open procedure, with a larger cut, or laparoscopically with a few small cuts. The doctor will talk to you about the best way to do your surgery.
  • If you have lost weight, you may need to improve your nutrition before the surgery. Ask to see a dietitian.
  • If your spleen is going to be removed you will need a pneumonia shot before the surgery.
  • You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.

What happens during the procedure?


  • Once you are in the operating room, the staff will put an IV in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
  • When you are asleep, the doctors put a tube in your mouth to help you breathe. They may also put another small tube in your nose. This one goes down to your stomach to drain out any food or fluid that might come out during surgery. You may have a tube in your bladder to drain urine.
  • Open Procedure:
    • Your doctor will make a large cut in your upper belly to see the pancreas and other parts.
    • Your blood vessels will be tied off. The pancreas and other organs are taken out.
    • Your doctor will sew your stomach and bowels back together after taking out the bad part of the pancreas.
    • Your doctor will close your cut with stitches or staples and cover it with clean bandages.

  • Laparoscopic Procedure:
    • Your doctor will make few small cuts in your belly. A scope with a tiny camera is put through one of the small cuts. Your doctor will put small surgical tools into the holes to do the procedure. To be able to view the site, gas will be put into the belly. Then, the pancreas or other organs will be taken out. Your stomach and bowels are sewn back together. Your doctor will close your cut with stitches or staples and cover them with clean bandages.
  • Your doctor may put in a G-tube, which is placed straight in the stomach. This will help prevent upset stomach and throwing up and give you nutrition while you are healing. The doctor may place this tube coming out of your stomach or your intestine.

What happens after the procedure?


  • You will go to the Recovery Room or Intensive Care Unit after the surgery and the staff will watch you closely. The staff will check your heartbeat, blood pressure, and breathing and give you drugs for pain.
  • Later that day or the next, you will get out of bed to walk around. The staff will help you start to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear. Use a pillow against your belly to support your wound when coughing.
  • You will stay in the hospital for a few days.

What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Get lots of rest. Rest when you are feeling tired.
  • Talk to your doctor about how to care for your cut site. Ask your doctor about:
    • When you should change your bandages
    • When you may take a bath or shower
    • If you need to be careful with lifting things over 10 pounds
    • When you may go back to your normal activities like work, driving, or sex
  • Be sure to wash your hands before touching your wound or dressing.
  • Your doctor may ask you to keep a record of your blood sugar readings. Your doctor may have you meet with a diabetes educator while you are in the hospital. The educator will talk with you about using a blood sugar meter to test your sugar levels. This is a glucometer. This person will tell you what to do if your blood sugar is too high or too low. The diabetes educator will also teach you how to take your drugs for blood sugar or your insulin shots.

What follow-up care is needed?


  • Your doctor will ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
  • Your doctor will tell you if you need other tests.
  • You may be asked to see a dietitian to plan for the right diet for you.

What lifestyle changes are needed?


  • Avoid getting into sports that involves rough contact to your belly.
  • Avoid smoking and drinking beer, wine, and mixed drinks (alcohol).
  • Eat small meals more often to keep your blood sugar at a steady level.

What drugs may be needed?


The doctor may order drugs to: ‚  
  • Prevent infection
  • Keep your bodys blood sugar in a good range
  • Help with digestion

What problems could happen?


  • Infection
  • Bleeding
  • You become a diabetic. Change your diet as ordered by your doctor.

When do I need to call the doctor?


  • Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, or wound that will not heal.
  • Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
  • Signs of high blood sugar. These include sleepiness, blurry eyesight, passing urine more often, more thirst, breath has a fruity sweet smell, upset stomach and throwing up, dizziness, or passing out.
  • Cannot get blood sugar under control
  • Very bad upset stomach and throwing up
  • Loose stools

Where can I learn more?


Cancer Research UK ‚  
http://cancerhelp.cancerresearchuk.org/type/pancreatic-cancer/treatment/surgery/which-surgery-for-pancreatic-cancer ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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