What are the indications of pancreatectomy?


The surgical removal of part or whole of pancreas by Best General Surgeon in Lahore  is called pancreatectomy. This procedure is commonly done to treat tumors of the pancreas, but can be done for other conditions as well. Read on to know more about pancreatectomy, its indications, types and complications:

What is pancreatectomy?

Pancreatectomy is the removal of part or whole of the pancreas—the digestive organ responsible for maintaining the blood sugar levels and releasing enzymes. Pancreas is located just underneath the stomach, and is the size of a hand. Conditions that damage the pancreas, including alcoholism, severe trauma, tumors and metastatic disease may necessitate partial or total removal of the pancreas, and this procedure is called pancreatectomy.

What are the indications of pancreatectomy?

The indications of pancreatectomy include:

  • Mucinous tumors
  • Chronic pancreatitis
  • Cystic tumors of the pancreas
  • Metastatic tumors that invade the pancreas such as those of the kidneys and duodenum
  • Severe trauma
  • Inflammatory conditions of the pancreas
  • Malignant tumors of the pancreas—ampullary cancers and adenocarcinomas
  • Cancers of the lower end of the bile duct

What are the types of pancreatectomy?

Pancreatomy may be:

  • Open
  • Laparoscopic
  • Total
  • Partial
    • Whipple’s procedure
    • Distal pancreatectomy
    • Central pancreatectomy

What are the complications of pancreatectomy?

The complications of pancreatectomy are based on immediate effects of the surgery, short-term side-effects of the procedure and the long-term effects:

  • Complications due to the surgery:
    • Bleeding
    • Anastomotic leak
    • Infection
    • Blood clots
  • Complications due to pancreatectomy include:
    • Paralytic ileus: following surgery, the bowels may have delayed movements. This is called paralytic ileus and mandates that the patient be put on liquid diet until normal movements return.
    • Dumping syndrome: in case of total pancreatectomy the major side effect of dumping syndrome is seen. This involves rapid emptying of the gastric contents into the intestines, instead of moderated release. Consequently, there is abdominal cramping, nausea, bloating and blood sugar changes.
    • Gastric side effects: gastric effects of pancreatectomy include delayed-emptying as the stomach is slow to release the digested food to the intestines. To treat this condition, healthcare providers prescribe drugs called
    • Fatigue: patients with pancreatectomy often complain of excessive fatigue. It is normal to feel tired and fatigued more than usual following pancreatic surgery. In such cases, it is best to rest and take naps as needed to allow the body to heal.
    • Weight loss: due to the dietary and metabolic changes that follow pancreatectomy, patients typically lose 10 to 15 pounds of weight. This weight loss subsides as time passes.
  • Long-term complications include:
    • Diabetes: in about 10 percent of the cases of partial pancreatectomy, enough insulin-producing beta cells of the pancreas are removed to cause diabetes. In case of total pancreatectomy, diabetes will always occur. In such cases, patient is put on insulin therapy to control the blood sugar levels.
  • Poor immunity: with distal pancreatectomy, there is also removal of the spleen. Spleen is an organ which is part of the immune system and is responsible for making B and T cells to fight infections. With removal of spleen, the immune system is impacted and may result in persistent infections.
  • Liver disease: due to the insufficiency of the pancreas to release digesting enzymes following the procedure, there are changes in the metabolism that result in excessive fat storage on the liver. This results in a condition called non-alcoholic fatty liver disease (NAFLD). Initially this may present without any symptoms, but if this condition persists, it can lead to chronic inflammation of the liver with progressive liver damage.
  • Exocrine insufficiency:  the pancreas is responsible for producing enzymes for digestion. With partial or complete removal of the pancreas, there are insufficient digestive enzymes produced, resulting in malabsorption and indigestion. This can cause a range of symptoms from diarrhea to malnourishment. In case of exocrine insufficiency, Best General Surgeon in Karachi may prescribe exogenous enzymes to improve digestion.

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