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Pancreatectomy

A pancreatectomy is the surgical removal of all or part of the pancreas. There are several types of pancreatectomy including pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy, the removal of the entire pancreas. These procedures are used to treat a number of conditions involving the pancreas including:

  • Inflammation
  • Necrotising pancreatitis
  • Severe chronic pancreatitis
  • Severe Trauma
  • Neoplasms
  • Adenocarcinoma (85% of all cancers in pancrea)
  • Cystadenoma (mucinous/serous)
  • Cystadenocarcinoma
  • Islet cell tumors (neuroendocrine tumors)
  • Papillary cystic neoplasms
  • Lymphoma
  • Acinar cell tumors
  • Cancer of the ampulla of Vater (ampullary cancer)
  • Duodenal cancer
  • Cancer of the distal (lower portion) of the bile duct.
  • Severe hyperinsulinemic hypoglycemia

pancreas_duodenum_and_small_intestine

The pancreas is an organ about the size of a hand located in the abdomen in the vicinity of the stomach, intestines, and other organs. It lies behind the stomach and in front of the spine. The pancreas has two critical functions in the body:

  1. The production juices that help digest food
  2. The production of hormones such as insulin and glucagon that maintain optimal blood sugar levels and help the body use and store energy from food.

The most common surgical procedure involving removal of a portion of the pancreas is called a pancreaticoduodenectomy (Whipple procedure) in which the surgeon removes cancerous parts of the pancreas, duodenum, common bile duct, and if required, portions of the stomach.

Among common consequences of complete or nearly complete pancreatectomy are deficiencies of pancreatic endocrine or exocrine function requiring replacement of insulin or digestive enzymes. The patient immediately develops type I diabetes, with little hope for future type I diabetes treatments involving the restoration of endocrine function to a damaged pancreas, since the pancreas is either partially or completely absent. Type I diabetes can be treated with careful blood glucose monitoring and insulin therapy.

Because the pancreas is responsible for the production of many digestive enzymes, a pancreatectomy should only be given as an option for pancreatic disease which is life threatening, such as pancreatic cancers. It is very important to note that even after a pancreatectomy, pain still exists in most patients.

A distal pancreatectomy is removal of the body and tail of the pancreas.

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