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The pancreatic cancer is found to be one of the fatal forms of gastrointestinal malignancy. But then fortunately selective group of patients do experience the benefits of a pancreatectomy surgical procedure when performed by skilled and experienced surgeons. In the recent years 5-10% decrease has been observed in the rate of mortality depending on how extensive the surgery was and the experience of the surgeon. At John Hopkins Medical Institution Baltimore a study revealed the death of 1.4% patient due to total pancreatectomy complications.
The total pancreatectomy procedure is very effective as pancreatic cancer treatment. Pancreas is an organ located close to stomach and almost about the size of the hand which is responsible for secreting insulin, enzymes and other hormones. The part closest to the small intestine (duodenum) is the thickest part of the pancreas called the head, while thinnest tapering part very close to the spleen is called the tail and the middle part is named the body.
Patients who need the surgery will have small tumors in the head of the pancreas and will suffer from jaundice. People undergoing a surgical removal of the tumor must be diagnosed with the problem early enough. They will show no evidence of the metastatic nature of cancer i.e. the spreading of the cancer. Depending upon the stage of the disease it shall be determined whether the pancreatectomy performed shall be total or distal.
In case of patients whose pancreas has undergone severe injury or trauma a partial pancreatectomy can be the solution. In this case the injury is suffered by the body and tail of the pancreas. Normal pancreatic tissue is also removed in such surgeries but there are hardly any side effects or minimal effect in the function of the pancreas like production of hormones, digestive enzymes and insulin.
In case of chronic pancreatitis the pancreatectomy is seldom performed. In this case the pancreas keeps getting inflamed which results in the damage of the organ. If left untreated it can lead to acute pancreatitis.
Pancreatic cancer prognosis reveals that larger the tumor, worse gets the chances of cure. But in rare cases it has been observed that even a tumor as large as 4-5 cm has been effectively removed. Technology and options of treatments have improved but still the pancreatic cancer is considered a very lethal ailment.
The reasons behind the chronic pancreatitis are mainly because of alcohol abuse or presence of gall stones. Other causes include
In case of cancerous tissues, they grow very rapidly in the organ without showing any symptoms till a condition is reached when the patient has actually reached a critical stage. After reaching the critical stage the patient can start showing various symptoms like
Total pancreatectomy procedure as such ideally speaking has no such alternative except for the fact that the kind of pancreatectomy can be varied in terms of the extent to which the pancreas has suffered damage. A pancreas transplant can also be considered in rare cases.
For the treatment of pancreatic cancer or chronic pancreatitis, there are quite a few treatment options:
It is a very demanding procedure and also known as pancreatoduodenectomy where a part of the pancreas, along with duodenum of the small intestine and the gallbladder is removed. Pancreas surgery usually aims at treating pancreatic cancer which is usually confined till the head of the pancreas. But in many cases it also aims at treating some of the tumors and abnormalities of the bile duct and small intestine. After the procedure the surgeon works to re attach the remaining portions of the digestive system to enable the patient to digest food normally and remove waste in a natural way from body.
In a total pancreatectomy the total pancreas gets removed along with gall bladder, spleen, common bile duct and some portions of the stomach and small intestine.
When there is a tumor in the bottom half of the pancreas like in the body or the tail, it must be removed with a distal pancreatectomy where this bottom half is removed surgically.
Pancreatectomy is performed to remove tumours (cancer, cysts, chronic infections) and/or sections of the pancreas that are damaged. Pancreatectomy is usually indicated in cases of pancreatic cancer, neuroendocrine carcinoid tumours, chronic pancreatitis, and precancerous conditions of the pancreas.
If you experience persistent abdominal pain, unintentional weight loss, yellowing of the skin and eyes (jaundice), difficulty eating (digestive issues), or a decrease in food intake and your doctor diagnoses a cancerous or non-cancerous pancreatic tumour or chronic pancreatitis, see a physician as soon as possible.
To prepare for a pancreatectomy, you will likely have tests done (blood work, CT scan/MRI), an endoscopic evaluation (to look at your digestive tract), an assessment of your nutritional state, fasting before the procedure, and an evaluation for anaesthesia. Depending on the situation, your doctor may advise adjusting your medications and performing bowel preparation prior to surgery.
In the operating room, a surgeon will remove either the entire pancreas or a portion of the pancreas using an open, laparoscopic, or robotic method while under general anaesthesia. The surgeon may also remove nearby organs and/or lymph nodes, depending on how extensive the disease is.
The pancreatectomy procedure will generally take between four and eight hours, depending on the complexity of your case and which surgical method will be utilised. Your average length of hospital stay following a pancreatectomy will be between seven and 14 days, and your recovery will continue for several weeks thereafter.
It includes removal of cancerous or diseased pancreatic tissue, improved survival in pancreatic cancer, relief from chronic pain in pancreatitis, prevention of disease progression, and improved quality of life
Restoration of Diet, Management of Pain, Supplementation of Enzymes and Monitoring of Blood Sugar during the Recovery Process. Most patients regain their strength within 6-8 weeks, and complete recovery may take many months with proper follow-up care.
While the likelihood of success for pancreatectomies differs greatly depending on etiology (cancer vs chronic pancreatitis), surgical type, and individual patient attributes, overall pancreatectomy outcomes tend to be favorable when performed on patients without cancers (with increasing levels of pain control) and improved survival rates in patients suffering from advanced forms of pancreatic cancer (60-80%) 1 year survival rate in early stage cancers).
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