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.
About the ailment
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.
Causes of Pancreatic Cancer
The reasons behind the chronic pancreatitis are mainly because of alcohol abuse or presence of gall stones. Other causes include
- Genetic mutations
- Age
- Food habits and drug abuse
- Chronic Pancreatitis
- Long standing Diabetes mellitus problem
- Obesity
What are pancreatic cancer symptoms?
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
- Pain experienced in the upper abdomen
- Jaundice where skin and eyes start yellowing
- Appetite loss
- Dark Urine formation
- Nauseating feeling and vomiting
- Back pain experienced
- Enlarged lymph nodes
- Stools turning paled colored
- Diarrhea
- Irritation felt in skin like itching
- Depression
- Back pain
- Weight loss experienced suddenly
- Symptoms of the digestive system very often dominate the pancreatic cancer symptoms since the organ is very close to the stomach.
What are my alternatives for total pancreatectomy?
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.
Pancreatic cancer treatment options
For the treatment of pancreatic cancer or chronic pancreatitis, there are quite a few treatment options:
What is the Whipple procedure?
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.
What is a total pancreatectomy?
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.
What is distal pancreatectomy?
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.
- Infection and bleeding
- Delayed gastric emptying
- Pancreatic fistula
- Diabetes due to reduced insulin production
- Digestive enzyme deficiency
- Blood clots and anesthesia-related risks
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+99Process Involved for Pancreatectomy
- Before surgery, the patient undergoes blood tests and imaging studies (e.g., CT scans, MRIs, or PET scans) to determine the size, location, and extent of pancreatic disease and to inform the surgical approach.
- The nutritionist assesses the patient’s nutrition, weight, and digestive function to optimise strength prior to surgery and minimise post-surgical complications.
- The anesthesiologist assesses whether the patient is fit for general anesthesia, and reviews their medical history, medications, and heart and lung function to ensure safety during surgery.
- The surgical approach to removing the pancreas will depend on the extent of the disease and will involve either an open, laparoscopic, or robotic approach.
- After surgery, patients will be monitored closely in the ICU for vital signs, pain levels, blood glucose levels, and gastrointestinal function to detect complications early.
- Rehabilitation after pancreatotomy includes returning to eating gradually, managing enzymes and insulin if necessary, receiving physical rehabilitation, and attending regular follow-up appointments to monitor healing and disease control.
- Pancreatic cancer
- Neuroendocrine tumors
- Pancreatic cysts and precancerous lesions
- Chronic pancreatitis
- Pancreatic trauma
- Whipple procedure (Pancreaticoduodenectomy)
- Distal pancreatectomy
- Total pancreatectomy
- Laparoscopic pancreatectomy
- Robotic-assisted pancreatectomy
- Patients diagnosed with pancreatic cancer, tumors, or cysts
- Individuals with chronic pancreatitis unresponsive to medical treatment
- Patients with precancerous pancreatic lesions
- Patients medically fit for major abdominal surgery
- No extensive cancer spread to distant organs
- Surgical staples
- Absorbable sutures
- Temporary drainage tubes
- Pancreatic stents (if required)
- Bile duct reconstruction
- Gastric or intestinal reconstruction
- Lymph node dissection
- Feeding tube placement
- Gallbladder removal
- Removal of cancerous or diseased pancreatic tissue
- Improved survival in pancreatic cancer
- Relief from chronic pain in pancreatitis
- Prevention of disease progression
- Improved quality of life
- Complete or partial removal of diseased pancreas
- Improved digestion with enzyme supplementation
- Better blood sugar control with proper management
- Reduced cancer recurrence risk
- Long-term disease control
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