Pancreas Resection

Pancreas Resection - What it is

The pancreas is an organ located behind the stomach and near the first part of the small intestine. It is divided into 4 sections: the head, neck, body, and tail.

The pancreas has 2 main functions:

It makes digestive fluids that help break down fats, carbohydrates and proteins.
It makes insulin and glucagon, hormones that help regulate blood sugar levels.

Pancreas resection is mainly performed to remove pancreatic cancer or a suspicious tumour (e.g. primary adenocarcinoma, neuroendocrine) or cyst. Biopsy of the tumour or cyst may be ordered before the surgery if necessary.

There are two main types of pancreatic resection:

Distal pancreatectomy or a Subtotal pancreatectomy
Whipple operation/Pancreaticoduodenectomy

A Distal pancreatectomy or a Subtotal pancreatectomy is a major operation to remove the left side of the pancreas (Body/Neck and Tail).
A Pancreaticoduodenectomy also known as a "Whipple” operation is a major operation to remove a part of the pancreas (Head and neck/uncinate process), the gallbladder, the common bile duct, part of small intestine and stomach in some cases.

What does it involve?

A surgical cut (incision) will be made to enter the abdomen. In some cases, a minimally invasive approach (key-hole or robot-assisted) may be suitable and recommended for you as they result in less pain, a shorter hospital stay and a faster recovery. The surgery usually takes about 4 to 8 hours, but the time may vary depending on the approach and complexity of the case.

Pancreas Resection - Symptoms

Pancreas Resection - How to prevent?

Pancreas Resection - Causes and Risk Factors

Pancreas Resection - Diagnosis

Pancreas Resection - Treatments

What are the risks and complications of pancreas resection?

Pancreatic Fistula: If the stitches on the pancreas do not heal properly, it is possible for the pancreatic juice to leak. While leakage typically stops on its own, some people may need further intervention or surgery.

Delayed gastric emptying: Removal of part of the stomach sometimes affects the normal motility and results in delayed passage of fluids and food into the small intestines. It typically resolves on its own, but some cases require assisted feeding through a tube or parenteral nutrition.

Bleeding: Bleeding is expected during the operation and is dealt with by the surgeon.

If it continues after the operation you may be given a blood transfusion, may require further intervention or return to the operating theatre.

Wound infection: This slows down the wound healing. Infections are treated promptly with antibiotics and dressings.

Nutritional malabsorption: Decreased production of pancreatic enzymes in some people can make it diffcult to absorb nutrients from food. This can lead to diarrhea and other gastrointestinal diffculties.

Diabetes: If a significant portion of the pancreas is removed, there is a chance this may result in you becoming diabetic. If this happens you may need to take regular insulin injections or medications to regulate the blood sugar levels.

Weight loss: People may lose 5-10 percent of their total body weight due to problems eating in the weeks following surgery.

Overwhelming post-splenectomy infection (OPSI): If your spleen is removed, there is a small risk of infection by certain bacteria. This risk will be minimized by vaccinations given to you about 2 weeks before the surgery.

Others: Other possible problems are similar to those seen with other major surgeries. These include blood clots, injury to other organs, urinary tract and lung infections. Precautions will be taken by the surgeons to minimise these complications e.g. prophylactic antibiotics, calf compressors etc.

What can I expect after the procedure?

The usual hospitalization period is between 7 – 10 days if no complications develop during the hospitalization. Time to feeding depends on the clinical condition.

Are there other treatments available?

You may opt out of the surgery. If left untreated, the possible complications include persistent pain and disease progression.

There are other treatments possible for pancreatic cancer but they are not curative in nature:

Chemotherapy - Pancreatic cancer may respond to chemotherapy to a certain extent.

Clinical Trials – Clinical trials test new drugs, surgical techniques and strategies. There may be suitable clinical trials available for selected patients. Please consult your specialist for advice.

Combination of various treatment options may be ordered as well to optimise the treatment results

Pancreas Resection - Preparing for surgery

Pancreas Resection - Post-surgery care

Pancreas Resection - Other Information

About SGH

The Singapore General Hospital (SGH) is Singapore’s flagship hospital. With more than 30 specialties, it provides comprehensive and multidisciplinary care backed by technology and the facilities to provide holistic and comprehensive patient care.

It is also the national referral centre for Haematology, Renal Medicine, Nuclear Medicine, Orthopedic Surgery, Pathology and Plastic Surgery (Burns).

As an academic healthcare institution, SGH provides postgraduate training and plays a major role in undergraduate training and clinical teaching for medical professionals locally and in the region. It is also committed to innovative translational and clinical research to provide the best possible care for patients.

Visit our website: https://www.sgh.com.sg/HPBTrS

General Enquiries (24hrs): 6222 3322

Outpatient Appointments: 6321 4377

GP Hotline: 6321 4402

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Overview

Hepatobiliary ＆ Pancreatic Surgery,

Pancreas Cancer,

Pancreatectomy

Article contributed by Hepato-pancreato-biliary and Transplant Surgery, Singapore General Hospital

The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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