What is Pancreatic Surgery?
Pancreas is a vital gland, located behind the stomach just below the liver. It produces several digestive enzymes and also plays a vital role in maintaining blood glucose levels. The pancreas is both an exocrine and an endocrine gland. The exocrine part produces enzymes that help in digestion and absorption of nutrients from food. The endocrine part of the pancreas secretes hormones involved in the metabolism of sugar and maintenance of blood sugar levels. Any disease or injury to the pancreas may cause several problems. Pancreatic surgery comprises of a wide range of surgical procedures.
Common Pancreatic Surgeries
Some of the commonly performed pancreatic surgeries include:
- Whipple Procedure: Also known as pancreaticoduodenectomy, is performed to treat cancers at the head (wide part) of the pancreas. During the procedure, the head of the pancreas, the gallbladder, duodenum, a part of the bile duct, and sometimes a part of the stomach are removed. The remaining bile duct, intestine, and pancreas are then reconnected so that enzymes and bile can flow back into the intestines.
- Distal pancreatectomy is usually performed when the cancer is found in the middle of the tapering end of the pancreas. This procedure takes less time and has a shorter period of recovery when compared to the Whipple procedure.
- Pancreatic necrosectomy is usually performed in terminally ill patients with severe acute pancreatitis and in patients with the dead or infected pancreas.
- Drainage procedure is performed to open the pancreatic ducts that are blocked due to chronic pancreatic damage. An incision is made from your chest to the abdomen, and the pancreas is exposed. The pancreatic duct can be opened from head to tail (Puestow procedure) or transversely at the neck and body (Du Val procedure) and connected to a loop of the small intestine, into which the pancreatic juices drain. The incision is then sutured. Complications associated with this procedure include bleeding and pancreatic fistula (due to leakage).
- Pancreas transplantation: This procedure is primarily indicated for type 1 diabetes. It involves removing your pancreas and replacing it with a healthy pancreas from a donor. The surgery is performed under general anesthesia. Your surgeon will make an incision in the middle of your abdomen and connect the pancreas and part of the intestine from the donor with your blood vessels. Your pancreas is not removed but retained to help indigestion. The surgery takes around 3 hours and is sometimes performed along with a kidney transplant, which then takes around 6 hours.
Following the surgery, you will be monitored in the ICU, and hospitalized for about 1 week. You will be prescribed anti-rejection medication to be used lifelong. The possible complications following the surgery include clots in arteries or veins of the new pancreas, development of cancer after a couple of years, inflammation of the pancreas, leakage of fluid from the new pancreas, and rejection. Infection, bleeding, diarrhea, weight loss and diabetes are common surgical complications of this procedure. You will be able to eat small amounts of easily digestible food and may have to take medications to assist digestion.
