Treatment

Total Pancreatectomy

Overview

A Total Pancreatectomy is a major surgical procedure where the entire pancreas is removed. In some cases, nearby organs like the gallbladder, spleen, part of the stomach, small intestine and bile duct may also be removed. This surgery is typically done to treat pancreatic cancer, severe chronic pancreatitis or other serious pancreatic conditions that can’t be managed with medication or smaller surgeries.

Since the pancreas controls both digestion and blood sugar levels, patients will need lifelong insulin therapy and digestive enzyme supplements after surgery. It is a life-changing treatment, but when carefully planned and managed, many patients can live healthy, active lives afterward.

Why Total Pancreatectomy is Required?

• When pancreatic cancer is widespread across the pancreas.
• For patients with severe chronic pancreatitis not improving with other treatments.
• If tumors affect multiple parts of the pancreas and are non-removable by other methods.
• For individuals with precancerous lesions across the pancreas, for example, IPMNs.
• When there is genetic risk of pancreatic cancer, and surgery is preventive.
• In some cases, as an alternative to Whipple procedure when disease spread is extensive.

Key Advantages of Total Pancreatectomy Treatment

• Offers a chance of long-term survival in pancreatic cancer cases.
• Completely removes the source of chronic pain in severe pancreatitis.
• Helps prevent cancer spread when performed at an early stage.
• Reduces the risk of recurrence in genetic or multifocal pancreatic conditions.
• Enables better planning for future health, with close insulin and enzyme control.

How Should You Prepare Yourself Before Total Pancreatectomy Treatment

• Undergo detailed imaging tests like CT scan, MRI, or PET scan to evaluate tumor spread.
• Share all medical history, allergies, and medications with your doctor.
• Stop blood thinners if advised.
• Follow fasting guidelines before surgery.
• Prepare for a longer hospital stay (around 1–2 weeks).
• Discuss insulin and enzyme replacement options post-surgery.
• Arrange for home support after discharge as recovery may take time.

How Total Pancreatectomy Treatment is Performed?

• The surgery is done under general anesthesia.
• The surgeon makes an incision (or uses a minimally invasive method) to access the pancreas.
• The entire pancreas is removed along with nearby organs if needed.
• Digestive tract is reconstructed to allow normal food flow.
• Drains and catheters may be placed temporarily after surgery.
• The total procedure usually takes 6 to 8 hours depending on complexity.

What You Can Expect Before, During and After Procedure?

• Before Procedure
• You will be admitted a day before for pre-op evaluations.
• IV line and anesthesia preparation will be done.
• During Procedure
• Entire pancreas and possibly nearby organs will be removed.
• New connections will be created between your stomach and intestines.
• After Procedure
• You will stay in ICU initially, then shift to a regular room.
• You will need insulin for life and enzyme replacement tablets to digest food.
• Diet changes and follow-ups with doctors are important for recovery.

Risk and Potential Complications

• Bleeding or infection during or after surgery.
• Delayed gastric emptying, making digestion slower.
• High blood sugar levels and lifelong diabetes (since pancreas is removed).
• Risk of malnutrition if enzyme supplements are not taken properly.
• Short-term fatigue, weight loss, or bowel changes post-surgery.

Results/Outcomes

• Success rate of total pancreatectomy is generally good when done by experienced surgeons.
• Offers significant pain relief and disease control in cancer or chronic pancreatitis.
• Most patients can return to a near-normal life with regular insulin and enzyme use.
• Recovery time after total pancreatectomy is usually 6–8 weeks.
• Quality of life improves over time with medical support, lifestyle adjustments, and follow-ups.