Pancreatectomy

Pancreatectomy

Overview

The most typical surgical procedure for pancreatic cancer is a pancreatectomy. This surgery removes all or part of the pancreas. 

Types

Types of pancreatectomies are:

  • Total pancreatectomy - Surgeons perform this less often than they perform the Whipple procedure (described below). During a total pancreatectomy, the surgeon removes the:
    • Entire pancreas
    • Distal common bile duct
    • Duodenum, which is part of the small intestine
    • Part of the stomach
    • Spleen
    • Gallbladder, if the patient still has one.
    • Once the surgeon removes the entire pancreas, the patient won’t be able to make pancreatic juices or insulin. The patient will need to test their blood glucose levels, give themselves insulin injections, and take other steps to keep blood glucose levels normal. The patient will also need to take pancreatic enzyme pills with food to aid in digestion.
  • Distal pancreatectomy
    • The surgeon will sometimes perform this surgery if cancer is confined to the tail of the pancreas. For this surgery, the surgeon removes only the tail of the pancreas, which is the thin part, and perhaps part of its body, the middle section. The surgeon also usually removes the spleen.

Other main types of surgery for pancreatic cancer are:

  • Whipple procedure (also called pancreaticoduodenectomy) - This surgery is the most common for completely removing tumors from the pancreas. The surgeon removes:
    • The gallbladder and part of the common bile duct.
    • In some cases, the body of the pancreas, which is the middle section
    • Part of the stomach
    • Duodenum, which is part of the small intestine
    • Lymph nodes near the bile duct
    • The head of the pancreas, which is the wide end
    • After this surgery, bile from the liver, food from the stomach, and digestive juices from the remaining part of the pancreas all enter the small intestine, so the patient can have normal digestion.
  • Pylorus-preserving pancreaticoduodenectomy - This surgery is similar to the Whipple procedure. However, the surgeon does not remove the lower part of the stomach.

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