Distal Pancreatectomy

Distal Pancreatectomy

Distal pancreatectomy refers to removing the removal of the body and tail of the pancreas. The remaining portion of the pancreas is over-sewn or stapled to seal the organ. This allows pancreatic fluid to drain into the small intestine as usual. There are three variations of distal pancreatectomy. The chosen variant depends on the location, type of tumor, and the patient’s physical state.

The traditional open approach is performed through a single large incision in the left side of the abdomen, most commonly under the ribs. This approach is usually required when the tumor is large and malignant or if blood vessels are nearby.

The laparoscopic approach is ideal for smaller, less aggressive tumors that are located closer to the tail of the pancreas. This approach can also be performed with the assistance of a surgical robot. Minimally invasive surgery requires only four small incisions, less scarring, less pain, and a shorter recovery time. One of the four incisions is slightly larger to allow for the removal of the pancreas. Up to 10% of the time, the surgery must be converted to open for patient safety.

Depending on the location of the tumor, the surgery may involve the blood vessels that supply the spleen. In this case, these blood vessels and the spleen must be removed. The spleen can often be spared if the blood supply is not affected.

The spleen is a large lymph node that protects against three bacteria (Pneumococcus, Neisseria meningitidis, and Haemophilus influenzae). Each of these bacteria has effective 5-year vaccines for patients without their spleens.

Distal Pancreatectomy Statistics and Risks

This procedure requires a few hours of operative time, and as with any surgery, some risks include:

Postoperative Dietary Expectations

After a distal pancreatectomy, most patients will not feel hungry and will experience nausea and bloating in the short term. Starting the second day after surgery, patients should be able to tolerate clear liquids, after which their liquid and solid consumption will be advanced based on how well they feel. Since the tail of the pancreas is located directly behind the stomach, the surgical procedure will create inflammation that, in turn, causes some stomach dysfunction. This dysfunction can last anywhere from a few days to a week or more; however, it is temporary. The stomach will begin to function normally after the inflammation caused by the surgery begins to subside. After surgery, patients with pancreatic enzyme leakage will require additional recovery time for the stomach to regain its normal function.

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