Pancreatic Surgery

What is pancreatic surgery?

There are a large number of pancreatic diseases that may need surgical treatment. Some of the more common pancreatic diseases that require surgery include pancreatitis, cysts on the pancreas, and pancreatic adenocarcinoma (cancer).

The various types of surgeries that can be done on the pancreas by general surgeons include:

Distal Pancreatectomy – this is where the body or tail of the pancreas is removed. It is often performed if a tumour is present in this area of the pancreas.

Total Pancreatectomy – this is the removal of the entire pancreas in order to remove multiple tumours, as well as long-term severe pancreatitis.

Whipple Procedure – this is where the head of the pancreas is removed due to tumours. In addition, the gallbladder, bile duct, and part of the duodenum is also removed. A small part of the stomach may also be removed. The remaining part of the pancreas is then re-connected to the rest of the digestive system.

Additional surgical procedures for pancreatitis include fluid drainage from the pancreas or opening of the pancreatic duct.

When should I see a specialist for pancreatic surgery?

Surgery is the only way pancreatic cancer can be cured. It is important to discuss your options with your surgeon to see if surgery is the best option for you.

Chronic pancreatitis can cause severe damage to the tissue of the pancreas. Surgery is done to remove this damaged tissue to help the pancreas function better.

Surgically removing pancreatic cysts is only needed in severe cases when there is a concern for cancer. Speak to your surgeon if you are unsure of whether surgery is appropriate or not.

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Did you know?

Early physicians thought the pancreas served no other function than to be a shock absorber for the stomach. This was because of its location as well as its rubbery texture.

What are the risks of pancreatic surgery?

Pancreatic surgery is major surgery that can carry some risk. Some of these include:

Bleeding – this can occur during or after surgery.

Infection – which can develop at the surgical site or deeper within the abdomen. Treatment is with antibiotics, and sometimes may require repeat surgery.

Intra-abdominal abscess – which counts for about 1 to 12% of patients following resection of the pancreas.

Developing diabetes – this is because the pancreas is the organ that produces a hormone that is needed to control blood sugar levels. You may be prescribed long-term medication to keep your blood sugar levels under control.

How do I prepare for pancreatic surgery?

Pancreatic surgery is complex and major. There will usually be some preparation involved before the day of your operation. This may vary depending on the type of surgery you are having, but you can usually expect the following:

You may need to stop taking certain medications, as some might increase your risk of complications. Talk to your surgeon or anaesthesiologist about any medication you are taking. It may be a good idea to bring your medication with you on the day of your operation.

You will usually be expected to stop eating and drinking a few hours, or even a day, before surgery. Your general surgeon will advise you on the specifics of this. You my also be required to do some bowel preparations prior to your surgery.

What can I expect during pancreatic surgery?

Once you are ready, and the surgical team are suitably prepared, you will be taken into an operating theater. Pancreatic surgery will always require general anaesthesia administered by an anaesthesiologist.

You will be connected to an echocardiogram (ECG) machine as well as a blood pressure machine to monitor your heart and circulation. Once you are asleep, you will also need a tube inserted into your airway to assist your breathing through your operation.

The surgical team will then proceed with the planned surgery. Because of the nature of anaesthetic medication, you will not have any memory of the procedure.

What happens after my pancreatic surgery?

Following your pancreatic surgery, you will be taken to a recovery area where you will be carefully monitored by nurses to ensure you wake up safely from the anaesthetic. Once they are happy that you are awake, you will be moved to a general ward to continue your recovery.

You will also have a drip attached, which allows fluid to be administered into your body to keep you hydrated. If you are in pain, your general surgeon can prescribe pain medication to keep you comfortable.

You can spend up anywhere from a few days to a few weeks in hospital depending on the type of surgery you had, and your rate of recovery. Your general surgeon will be able to advise you about when you will be able to return to normal duties.