Pancreatectomy is surgery to remove part or all of your pancreas. It’s usually done to treat cancer, and sometimes, severe chronic pancreatitis. Removing part or all of your pancreas can have lifelong consequences for your digestive system. You may need to take insulin and digestive enzymes from now on.
A pancreatectomy is surgery that removes part or all of your pancreas. Your pancreas is part of your digestive system. It has two main functions. It makes enzymes that help break down food for digestion, and it makes hormones that help maintain your blood sugar levels and store energy from food.
Tumors and pancreatitis are the two most common reasons why healthcare providers recommend a pancreatectomy.
Tumors are at risk of spreading to other parts of your body, and removing them from your pancreas helps reduce that risk. Pancreatitis happens when your pancreas becomes inflamed. It can lead to severe pain and other complications, which can be an indication for a pancreatectomy.
Conditions that may be treated with pancreatectomy include:
Your pancreas is shaped a bit like a fish, with a wide “head,” a moderate “body” and a narrower “tail.” Different procedures may remove the head, tail, middle or all of the pancreas. Sometimes, other nearby organs and vessels also need to be removed.
Yes, you can, but not without side effects. Without the enzymes and hormones that your pancreas once produced, you’ll have difficulties regulating your blood sugar and absorbing nutrients from your food. You’ll need supplemental therapies to replace them.
You might. As your pancreas is where your natural insulin comes from, removing much of it could make you dependent on insulin therapy. However, a partial pancreatectomy does leave some insulin-secreting cells behind, and sometimes they’re enough.
If you’re having a total pancreatectomy, you’ll have diabetes afterward unless your surgeon can preserve some of your insulin-producing cells. This depends on your condition. Sometimes, your surgeon can transplant some of these cells into your liver.
You may have to take several steps to prepare for surgery in the days ahead. These might include:
Testing: You’ll meet with a nurse practitioner for presurgical testing. They’ll review your medical history and current medications with you. You may have some standard medical tests to make sure you’re in good health for the surgery, such as a chest X-ray or EKG.
Quitting: Your nurse will also ask about your current alcohol use. It’s important to be honest about this. Alcohol use can cause certain complications during and after the surgery. Your healthcare team can help you stop safely and treat your withdrawal symptoms as necessary.
Medications:You may be given an antiseptic skin cleanser to clean with before the procedure. This will help prevent bacterial infections after surgery. You may need to stop taking certain medications, such as NSAIDs and blood thinners, some days before.
When it’s time for surgery, your healthcare team will help you onto the operating bed and your anesthesiologist will deliver anesthesia through an IV line in your arm. This will put you to sleep for the procedure. Your IV will continue to deliver fluids and medicine, and sometimes nutrition.
Your healthcare team will place various tubes to support your body while you’re under anesthesia. You’ll have a tube in your windpipe to help you breathe and one in your stomach to prevent nausea. You’ll have a Foley catheter to drain your pee and tubes in your abdominal cavity to drain excess fluids.
Most pancreatectomies are performed through open surgery, which offers ready access to many organs at once. Some medical centers may be able to perform certain pancreatectomies through minimally invasive methods, such as laparoscopic or robotic surgery. These methods make recovery a little easier.
If you’re having open surgery, your surgeon will make one long incision across your abdomen to open your abdominal cavity. If you’re having laparoscopic or robotic surgery, your surgeon will make several small “keyhole” incisions. They’ll operate through these, using long tools and a camera (laparoscope).
A central or distal pancreatectomy takes about four hours. A total pancreatectomy or Whipple’s procedure takes about six hours.
You’ll be moved to a hospital room where your healthcare team will closely monitor your health and vital signs. You’ll have some of your tubes in place still that’ll likely be removed in the coming days. You’ll be in the hospital for about a week, sometimes a little more.
During your stay, you’ll gradually wean from your on-demand pain medication. You’ll be helped out of bed starting on the first day after surgery and begin moving around a little more each day. You’ll gradually transition from a liquid diet to more solid foods. You may be constipated at first. Your nurse can help with this.
Your healthcare team will also be monitoring your digestion and blood glucose levels after your pancreatectomy. They’ll need to know how you’re doing with your reduced pancreatic function. They’ll adjust your diet and prescription medications accordingly.
Healthcare providers only recommend a pancreatectomy when it’s medically necessary. That usually means that you have cancer in your pancreas and that surgery could help you live longer. Sometimes, another disease is causing persistent problems, and surgery is the only solution.
Complications that may occur during surgery include:
After the procedure, short-term side effects may include:
You’ll have long-term complications after a total pancreatectomy or after any pancreatectomy that removes enough of your pancreas to impact its functionality. You may also have complications from the loss of other organs that need to be removed during your pancreatectomy. Some of these include:
Recovery at home may take four to eight weeks, depending on your baseline health going into the operation, as well as the extent of the operation and whether you had minimally invasive or open surgery.
Call your healthcare provider if you have:
A note from Cleveland Clinic
A pancreatectomy is a serious operation that can have lifelong consequences for your digestive system. But if your healthcare provider has recommended a pancreatectomy, it’s because they believe the benefit to you is worth it. Whether you have a life-threatening condition or one that severely diminishes your quality of life, a pancreatectomy could cure it. Your healthcare provider will walk you through the pros and cons of your condition and help prepare you for the best outcome.
Last reviewed by a Cleveland Clinic medical professional on 05/24/2022.
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