Have you heard of a small but very important organ that works silently inside our bodies to digest the food you eat and control blood sugar levels? That is the pancreas, or as we call it in English, the pancreas. Sometimes, due to certain diseases that occur in this important organ, part or all of it has to be removed surgically. That is what we call a pancreatectomy. It is normal to feel a little scared when you hear about such a surgery. That is why, today we will talk about it simply, in a way that you can understand.
Why do you need to have this Pancreatectomy surgery?
Doctors usually recommend major surgery like this only after careful consideration and only if it is absolutely necessary. There are two main reasons for this.
1. Tumors: Some tumors that form in the pancreas can be cancerous. These have a high risk of spreading (metastatic) to other parts of the body. So the best way to reduce that risk is to remove the part of the pancreas that contains the tumor.
2. Pancreatitis: This is when the pancreas becomes inflamed. This can cause severe pain and other complications. Sometimes, when the condition becomes too severe to control, surgery may be necessary.
In addition, this surgery is also used as a solution for conditions such as pancreatic cysts and certain hormone-producing tumors (pancreatic neuroendocrine tumors).
What are the types of pancreatectomy surgeries?
Our pancreas is shaped a bit like a fish. It has a wide " head ", a middle "body", and a thin "tail". So, depending on where the disease is, the part that is removed varies. Accordingly, there are several types of surgery.
| Type of surgery | Simply put, what is happening? |
|---|---|
| Distal Pancreatectomy | In this, the "tail" part of the pancreas, and sometimes the "body" part, is removed. Since this part is very close to the spleen, it is often removed along with the spleen . |
| Central Pancreatectomy | This is a slightly more complicated and less common surgery. It involves removing only the " head " and "tail" and leaving the middle "body" intact . This allows for greater preservation of pancreatic function. |
| Pancreaticoduodenectomy (Whipple procedure) | This is what many people know as the "Whipple" operation. In this, the " head " of the pancreas is removed. At the same time , the first part of the small intestine (duodenum), the gallbladder, and the common bile duct that are connected to it are also removed . Then, the remaining pancreas, bile duct, and stomach are reconnected to the small intestine. |
| Total Pancreatectomy | As the name suggests, this involves removing the entire pancreas . This surgery is done when the disease has spread throughout the entire organ or when no healthy tissue can be saved. Along with the pancreas, it also involves removing the spleen, gallbladder, the first part of the small intestine, and part of the stomach. |
Is it possible to live without a pancreas?
Yes, you definitely can. But with some changes. Because you lose the enzymes and hormones produced by the pancreas, you have to take them externally for the rest of your life.
Simply put, you have to take enzymes that help with digestion (Pancreatic Enzyme Replacement Therapy - PERT) in the form of pills, and the insulin hormone that controls blood sugar (insulin) in the form of injections.
Will I get diabetes then?
This is a problem for many people. If only part of the pancreas is removed, the remaining part may or may not produce enough insulin for the body. It depends on the part that is removed. However, if the entire pancreas is removed (Total Pancreatectomy), you will definitely develop diabetes . Because the insulin-producing cells are completely gone. At the same time, you will have to start insulin treatment.
What happens before, during and after the surgery?
Before the surgery...
You need to prepare a few days before the surgery.
- Tests: You may need to have several tests, such as blood tests, a chest X-ray, and an EKG, to check your health.
- Quitting bad habits: If you are an alcoholic, you should definitely tell your doctor about it. Alcohol can cause complications during and after surgery. The medical team will help you stop it safely.
- Medication: Sometimes you will be asked to stop taking blood thinners a few days before surgery.
During the surgery...
On the day of surgery, the anesthesiologist will put you completely asleep with an IV line in your arm. So you won't feel any pain. The surgery can take between 4 and 6 hours. The surgeon will perform the surgery either through an incision in your abdomen (open surgery) or through a few small incisions with the help of a camera (laparoscopic or robotic surgery).
After the surgery...
After the surgery, you will be transferred to a ward and your condition will be closely monitored. You will stay in the hospital for about 7 days.
- First, they are given liquid food and then gradually introduced to regular food.
- Painkillers are given as needed.
- From the day after surgery, you will be helped out of bed and walked around a bit with the help of the nurses. This is very important for a speedy recovery.
- The medical team is constantly checking your blood sugar levels and digestive process.
What are the risks and complications of this surgery?
Like any surgery, there are some risks involved. But doctors perform this surgery because the benefits outweigh the risks.
| Type of complication | Description |
|---|---|
| Short-term side effects (shortly after surgery) | |
| Weight loss | It is normal to lose about 5-7 kilos after surgery. This is due to changes in diet and the body's ability to heal. Over time, the weight will stabilize. |
| Fatigue | Because your body is using a lot of energy to heal itself from the inside, you may feel more tired than usual. It's normal to feel fine one day and tired the next. Get plenty of rest. |
| Digestive problems | Sometimes, the bowels may be a little less active (Paralytic ileus). Also, the release of food from the stomach may be delayed (Delayed gastric emptying). These are temporary. |
| Long-term complications | |
| Diabetes | As we discussed earlier, removing the entire pancreas will inevitably result in diabetes. |
| Exocrine Pancreatic Insufficiency | Insufficient production of enzymes needed for digestion. This can cause symptoms such as bloating and diarrhea. This requires taking enzyme pills (PERT) . |
| Decreased immunity | If the spleen is removed during surgery, the ability to fight off certain infections will be reduced. Therefore, the doctor may recommend getting certain vaccines . |
How long does it take to recover? And when should I see the doctor?
It can take anywhere from 4 to 8 weeks to fully recover after returning home, depending on your physical health and the nature of the surgery.
If you have the following symptoms, call your doctor immediately:
- If the surgical wound is swollen, red, or oozing pus-like fluid.
- If the fever is over 100 degrees F (37.7 C).
- If you have persistent diarrhea or constipation.
- If the pain is getting worse.
Take-Home Message
- Pancreatectomy is a major surgery that removes a diseased part or all of the pancreas. It is done for life-threatening conditions such as cancer.
- After surgery, it is possible to live without a pancreas, but lifelong treatments such as enzyme pills for digestion and insulin to control diabetes may be required.
- Although this surgery can be a bit scary, the medical team will provide you with the best treatment and support you need.
- If you have any questions, fears, or doubts about this, please discuss them with your doctor without hesitation.
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