Treatment

Distal Pancreatectomy

Overview

Distal pancreatectomy is a surgical procedure in which the tail and body of the pancreas are removed while preserving the head. In many cases the spleen is also removed along with the pancreas known as distal pancreatectomy and splenectomy. This procedure is commonly performed to treat benign or cancerous tumors, cysts or chronic pancreatitis in the distal part of the pancreas.

Why Distal Pancreatectomy is Required?

A distal pancreatectomy procedure is usually recommended for conditions affecting the left side of the pancreas, such as:

• Pancreatic tumors (benign or malignant)
• Cysts or pseudocysts that may cause discomfort or complications
• Chronic pancreatitis that does not respond to other treatments
• Neuroendocrine tumors such as insulinomas or gastrinomas
• Trauma or injury to the pancreas
• Cancers that have not spread beyond the pancreas

If the spleen is also affected a distal pancreatectomy with splenectomy is performed to ensure complete removal of diseased tissue.

Key Advantages of Distal Pancreatectomy

• Targeted removal: Only the affected part of the pancreas is removed leaving the healthy portion intact.
• Minimally invasive option: In many cases, laparoscopic or robotic surgery can be performed leading to faster recovery.
• Effective treatment: Helps eliminate tumors and cysts, reducing the risk of further complications.
• Improved quality of life: Many patients experience relief from pain and symptoms after surgery.

How Should You Prepare Yourself Before Taking Distal Pancreatectomy Treatment?

Before undergoing surgery doctor will guide you through important steps, including:

• Medical Evaluation: Blood tests, imaging (CT scan or MRI) and other assessments to ensure you are fit for surgery.
• Dietary Changes: You may be asked to avoid certain foods or follow a special diet.
• Medications: Some medications, such as blood thinners may need to be stopped before surgery.
• Vaccinations: If a distal pancreatectomy with splenectomy is planned vaccinations are recommended to prevent infections after spleen removal.
• Fasting: You may need to stop eating and drinking a few hours before the procedure.

How Distal Pancreatectomy is Performed?

The distal pancreatectomy steps involve:

• Anesthesia: The patient is given general anesthesia for a pain free procedure.
• Incision: The surgeon makes small (for laparoscopic) or larger (for open surgery) incisions in the abdomen.
• Removing the affected part: The diseased portion of the pancreas is carefully removed. If necessary the spleen is also removed (distal pancreatectomy and splenectomy).
• Closure: The incisions are closed using sutures or staples.

What You Can Expect?

1. Before the Procedure:

• Pre surgical evaluations and discussions with your doctor.
• A clear understanding of risks, benefits and recovery expectations.

2. During the Procedure:

• The surgery may take 2 to 4 hours depending on the complexity.
• If laparoscopic surgery is performed the recovery time may be shorter.

3. After the Procedure:

• Hospital Stay: Most patients stay in the hospital for 3 to 7 days after surgery.
• Pain Management: Pain medications will be provided for comfort.
• Dietary Adjustments: A gradual shift from liquids to solid foods as tolerated.
• Activity Restrictions: Limited physical activity is advised for a few weeks.

Risk and Potential Complications

While distal pancreatectomy complications are rare, some risks include:

• Infection at the surgical site.
• Bleeding or blood clots.
• Pancreatic leak leading to fluid accumulation.
• Digestive issues due to pancreatic enzyme changes.
• Diabetes if a large portion of the pancreas is removed.
• Weakened immune system if the spleen is removed (life after distal pancreatectomy and splenectomy requires extra precautions).

Results/Outcomes

• Life expectancy after distal pancreatectomy and splenectomy is generally good if there are no complications.
• Quality of life after distal pancreatectomy is often positive, with patients returning to daily activities after a few months.
• Distal pancreatectomy vs Whipple: The Whipple procedure is more complex and involves removing more organs. Distal pancreatectomy is a less extensive surgery with quicker recovery.
• Diet after distal pancreatectomy and splenectomy: A balanced diet rich in proteins, healthy fats, and fiber is recommended to support healing.