Search - Pancreatectomy

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Description

Pancreatectomy is the surgical removal of all or a part of the pancreas. It is the most effective treatment for cancer of the pancreas, an abdominal organ that secretes digestive enzymes, insulin, and other hormones. While surgical removal of tumors in the pancreas is preferred, it is only possible in the 10-15% of patients who arediagnosed early enough for a potential cure. Depending on part of pancreas removed, the procedure can be categorized into Total Pancreatectomy, in which case the entire organ is removed, usually along with the spleen, gallbladder, common bile duct, and portions of the small intestine and stomach.Distal Pancreatectomy, meaning that only the body and tail of the pancreas are removed, leaving the head of the organ attached.Whipple Procedure: When the duodenum is removed along with all or part of the pancreas, the procedure is called a Pancreaticoduodenectomy or Whipple's procedure. Total Pancreatectomy, in which case the entire organ is removed, usually along with the spleen, gallbladder, common bile duct, and portions of the small intestine and stomach. Total Pancreatectomy Distal Pancreatectomy, meaning that only the body and tail of the pancreas are removed, leaving the head of the organ attached. Distal Pancreatectomy Whipple Procedure: When the duodenum is removed along with all or part of the pancreas, the procedure is called a Pancreaticoduodenectomy or Whipple's procedure. Whipple Procedure

Symptoms

The surgeon will recommend the procedure in following medical conditions: Inflammation in the pancreasNecrotising pancreatitisChronic pancreatitis with painTraumaNeoplasmsAdenocarcinoma (85%)Cystadenoma (mucinous/serous)CystadenocarcinomaIslet cell tumors (neuroendocrine tumors)Papillary cystic neoplasmsLymphomaAcinar cell tumorsSevere hyperinsulinemic hypoglycemia Inflammation in the pancreasNecrotising pancreatitisChronic pancreatitis with pain Necrotising pancreatitisChronic pancreatitis with pain Necrotising pancreatitis Chronic pancreatitis with pain Trauma NeoplasmsAdenocarcinoma (85%)Cystadenoma (mucinous/serous)CystadenocarcinomaIslet cell tumors (neuroendocrine tumors)Papillary cystic neoplasmsLymphomaAcinar cell tumors Adenocarcinoma (85%)Cystadenoma (mucinous/serous)CystadenocarcinomaIslet cell tumors (neuroendocrine tumors)Papillary cystic neoplasmsLymphomaAcinar cell tumors Adenocarcinoma (85%) Cystadenoma (mucinous/serous) Cystadenocarcinoma Islet cell tumors (neuroendocrine tumors) Papillary cystic neoplasms Lymphoma Acinar cell tumors Severe hyperinsulinemic hypoglycemia

Pre Procedure

Patients with symptoms undergo some tests before the surgery is considered. These are UltrasonographyX-Ray ExaminationsComputed Tomography Scans (CT scan)Endoscopic Retrograde Cholangiopancreatography (ERCP) Ultrasonography X-Ray Examinations Computed Tomography Scans (CT scan) Endoscopic Retrograde Cholangiopancreatography (ERCP) Such tests are required to establish a correct diagnosis for the pancreatic disorder and in the planning the surgery. Since many patients with pancreatic cancer are undernourished, appropriate nutritional support, sometimes by tube feedings, may be required prior to surgery. Some patients with pancreatic cancer deemed suitable for a Pancreatectomy will also undergo chemotherapy and/or radiation therapy.

During Procedure

The combination of general anesthesia and Thoracic epidural anesthesia (TEA) has become the technique of choice at many trusted hospitals for major abdominal surgery. TEA reduces sympathetic activity, thereby influencing the perioperative function of vital organ systems. Thoracic epidural anaesthesia has been used widely to provide excellent pain relief, to attenuate the catabolic response to abdominal surgery.A pancreatectomy can be performed through an open surgery technique, or it can be performed laparoscopically. The abdomen is filled with gas, usually carbon dioxide, to help the surgeon view the abdominal cavity. A camera is inserted through one of the tubes and displays images on a monitor in the operating room. 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. If the pancreatectomy is total, the surgeon removes the entire pancreas and attached organs. The procedure is started by dividing and detaching the end of the stomach, followed by removal of the pancreas along with the connected section of the small intestine, the common bile duct and the gallbladder.

Post Procedure

Pancreatectomy is major surgery. Therefore, extended hospitalization is usually required with an average hospital stay of 2 to 3 weeks. Some pancreatic cancer patients may also receive combined chemotherapy and radiation therapy after surgery. This additional treatment has been clearly shown to enhance survival rates. After surgery, patients experience pain in the abdomen and are prescribed pain medication. Follow-up exams are required to monitor the patient's recovery and remove implanted tubes. After a total Pancreatectomy, the body loses the ability to secrete insulin, enzymes, and other substances; therefore, the patient has to take supplements for the rest of life. Depending on the medical condition, a pancreas transplantation may be considered as an alternative for some patients. Patients usually resume normal activities within a month. Doctor will suggest to avoid heavy lifting for six to eight weeks following surgery and not to drive as long as they take narcotic medication.

Risk And Complications

There is a fairly high risk of complications associated with any Pancreatectomy procedure. Commonly known complications are: Postoperative bleeding, which increases the mortality risk to 20–50%. In cases of postoperative bleeding, the patient may be returned to surgery to find the source of hemorrhage, or may undergo other procedures to stop the bleeding.Delayed Gastric Emptying, a condition in which food and liquids are slow to leave the stomach. To manage this problem, many surgeons insert feeding tubes at the original operation site, through which nutrients can be fed directly into the patient's intestines.Pancreatic Anastomotic Leak. This is a leak in the connection that the surgeon makes between the remainder of the pancreas and the other structures in the abdomen. Most surgeons handle the potential for this problem by checking the connection during surgery. Postoperative bleeding, which increases the mortality risk to 20–50%. In cases of postoperative bleeding, the patient may be returned to surgery to find the source of hemorrhage, or may undergo other procedures to stop the bleeding. Delayed Gastric Emptying, a condition in which food and liquids are slow to leave the stomach. To manage this problem, many surgeons insert feeding tubes at the original operation site, through which nutrients can be fed directly into the patient's intestines. Pancreatic Anastomotic Leak. This is a leak in the connection that the surgeon makes between the remainder of the pancreas and the other structures in the abdomen. Most surgeons handle the potential for this problem by checking the connection during surgery.
Hospital

Metro Manas Arogya Sadan Heart Care & Multi Speciality Hospital

  Shipra Path, Near Technology Park, Mansarovar, Jaipur, Rajasthan 302020.

0141-2786001
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  Sec- Prathap Nagar-, 28, Kumbha Marg, Sector 6, Sanganer, Jaipur, Rajasthan 302033.

0141-7122222
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Ganadhipati Purushottam Shekhawati Hospital & Research Centre

  A/2, Opp Time Square, Central Spine, Vidhyadhar Nagar, 302023.

0141-2232211
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G. P. Shekhawati Hospital & Research Centre (GPHRC), Jaipur, NABH, NABL, Accredited Hospital with ISO certified & Five Star Rating for Building (Issued by: Mini....



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