Today we are going to talk about a very important organ in your body that we don't talk about much, but that is the pancreas. Perhaps a doctor has told you or someone you know about pancreatic surgery. At that time, it is normal to be afraid and have many questions. So today, let's talk about this surgery to remove the pancreas, that is, 'Pancreatectomy', clearly and simply.
First, let's see what this surgery (Pancreatectomy) is.
Simply put, a pancreatectomy is a surgical procedure that removes part or all of your pancreas. Now you may be wondering, "What is a pancreas? What does it do?"
The pancreas is a small organ located inside our abdomen, behind the stomach. But its job is huge. It does two main things:
1. Making enzymes that help digest food: These enzymes help break down the nutrients in the food we eat so that the body can absorb them.
2. Making hormones: This is what makes important hormones like insulin, which controls your blood sugar levels.
So why remove such an important organ? Let's look at the reasons.
Why would someone need to have a Pancreatectomy?
Doctors only resort to major surgery like this when absolutely necessary. The two main causes are tumors and pancreatitis.
- Tumors: Some tumors that develop in the pancreas can be cancerous. These have a high risk of spreading to other parts of the body. So to reduce that risk, the part or all of the pancreas that has the tumor may need to be removed.
- Pancreatitis: This is a condition in which the pancreas becomes swollen and inflamed. Sometimes, if this continues (chronic pancreatitis), it can cause unbearable pain and other complications. In such cases, this surgery is also suggested as a solution.
This surgery is performed for the following conditions:
- Pancreatic cancer
- Pancreatic neuroendocrine tumors, for example, insulinoma
- Cancer that has spread to the pancreas from elsewhere (Metastatic cancer)
- Pancreatic cysts (tumors or fluid-filled sacs in the pancreas)
- Severe, long-term pancreatitis (Severe chronic pancreatitis)
What are the types of pancreatectomy surgeries?
The pancreas is shaped a bit like a fish. It has a large "head," a middle "body," and a thin "tail." The name of the surgery varies depending on the part that is removed. Sometimes, it is necessary to remove not only the pancreas but also other nearby organs.
| Type of surgery | Simply put... |
|---|---|
| Distal pancreatectomy | In this, the tail of the pancreas (and sometimes the middle part) is removed. Because the tail of the pancreas is very close to the spleen, the spleen is often also removed during this surgery. |
| Central pancreatectomy | In this , only the middle part of the pancreas is removed, leaving the head and tail. This is a somewhat complicated surgery that cannot always be performed. But if it can be done, it can preserve more of the function of the pancreas. |
| Pancreaticduodenectomy (Whipple procedure) | This is the more popular "Whipple procedure." The head of the pancreas is removed. At the same time, the first part of the small intestine (duodenum) , the gallbladder, and part of the bile duct that are connected to it are also removed. Then the remaining parts are reconnected. |
| Total pancreatectomy | As the name suggests, the entire pancreas is removed. This is done when the disease has spread throughout the organ or when no healthy tissue can be saved. Along with the pancreas , the spleen, gallbladder, the first part of the small intestine, and the lower part of the stomach also need to be removed. |
Is it possible to live without a pancreas?
Yes, you can. But it's a challenge. When you lose your pancreas, your body doesn't get the enzymes and hormones it produces. So you have to take them from outside for the rest of your life.
For example, you need to take digestive enzymes in pill form. Also, you develop diabetes because you don't have the hormone insulin. You have to take insulin injections for that. You have to learn to live with these.
What happens before the surgery?
You are well prepared before a major surgery like this.
- Tests: Your medical team will ask about your health history, the medications you are taking, and perform several tests, such as a chest X-ray and an EKG, to see if you are a good candidate for surgery.
- Quitting bad habits: If you drink alcohol, it's important to tell your doctor the truth. Alcohol can cause complications during and after surgery. Your medical team will help you quit safely.
- Medication: To prevent infection after surgery, you may be given a special solution to clean the skin before surgery. You may also be asked to stop taking certain medications, such as blood thinners, for a few days.
What happens during the surgery?
On the day of your surgery, you will be taken to the operating room. The anesthesiologist will put you into a deep sleep by giving you medication through a cannula (IV line) in your arm. You will not feel anything. While you are asleep, fluids and medications will continue to be given to your body through the cannula.
You will be connected to a tube to help you breathe, a tube to prevent stomach problems, and a Foley catheter to drain urine. Don't worry, this is all for your safety.
Most of the time, this surgery is done through a large incision in the abdomen (open surgery). This allows the surgeon to see the organs better. However, in some advanced hospitals, this surgery is performed through a few small incisions with a camera and instruments. This is called laparoscopic or robotic surgery . This reduces the recovery time.
This surgery usually takes between 4 and 6 hours.
What happens after the surgery?
After the surgery, you will be transferred to a ward or intensive care unit, where you will be closely monitored. Some of the tubes you have connected will be removed in a few days. You will usually stay in the hospital for about a week.
- Pain medication is given in the early days.
- From the day after surgery, you will be made to get out of bed and walk around a bit.
- First, they are given liquid food and then gradually introduced to regular food.
- The medical team is constantly monitoring your digestion and blood sugar levels, and will adjust your diet and medication accordingly.
Risks and complications of surgery
Like any major surgery, there are some risks, but doctors do their best to manage these risks.
| Type of risks and complications | Description |
|---|---|
| Short-term side effects | |
| Infections and bleeding | It can occur during or after surgery. |
| Anastomotic leak | Leakage from areas such as reattached intestines. |
| Decreased bowel function (Paralytic ileus) | Bowel movements may not be normal for a few days after surgery. This is normal. |
| Dumping syndrome | Discomfort after eating occurs when food moves too quickly from the stomach into the small intestine. This is often temporary. |
| Weight loss and fatigue | It is normal to lose weight and feel tired after surgery because the body uses a lot of energy to heal. |
| Long-term complications | |
| Diabetes | If the entire pancreas is removed, diabetes will definitely occur. It can also occur if part of the pancreas is removed. |
| Digestive problems (Exocrine pancreatic insufficiency) | Insufficient enzymes produced by the pancreas can cause symptoms such as bloating and diarrhea. For this, enzyme tablets (PERT) should be taken. |
| Decreased immunity | If the spleen is removed during surgery, the ability to fight off certain infections is reduced, so the doctor may recommend getting certain vaccines. |
How long does it take to recover after returning home?
It can take anywhere from 4 to 8 weeks to fully recover after you return home. This depends on your pre-surgery health and the type of surgery you had.
When to call the doctor immediately
If you have the following symptoms after returning home, call your doctor immediately.
- If the surgical wound is swollen, red, or oozing pus-like fluid.
- Fever (over 100 degrees Fahrenheit).
- Persistent diarrhea or constipation.
- New or worsening pain.
This surgery is a serious, life-changing procedure. But remember, a doctor is recommending it because they believe the benefits to your life far outweigh the risks. It is something that is done to save your life or improve your quality of life.
Take-Home Message
- Pancreatectomy is the surgical removal of part or all of the pancreas.
- This is mainly done for conditions such as pancreatic cancer and severe pancreatitis.
- After surgery, you can live without a pancreas, but you will need lifelong supplements like enzyme pills to help digest food and insulin to control diabetes.
- This is a major surgery and will take time to heal. It is very important to follow your doctor's instructions during that time.
- If you have any questions or concerns about this, talk to your doctor about it openly. They will provide you with all the information and support you need.
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