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Pancreatectomy: Symptoms, Classification, Diagnosis & Recovery

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.

Numbers of tests are conducted before the procedure including x-ray, computed tomography scans and endoscope retrograde cholangiopancreatography (ERCP) which aims at seeing the bile duct. It can also include angiography, and biopsies to test sample regions where cancer is suspected.

At times nutritional supplements are also given to patients since they can be malnourished. Additionally the tumor may be exposed to radiation therapy or chemotherapy to bring down the risks and reduce its spread and size.

This is a major surgery requiring prolonged hospital stays as long as 2 to 3 weeks. So depending upon those, pain medications to reduce pain in abdomen and additional chemotherapy and radiation therapy may be given. People usually suffer from a condition named pancreatic insufficiency where the body is no more able to produce digestive enzymes, insulin and other hormones. This is treated with pancreatic enzyme replacement therapy where externally insulin and enzymes are supplied to the body.

Pros and Cons

Pros

  • 50% to 65% patients have reported no pain after surgery
  • Recovery is around a month
  • Mortality rate has lowered down to 5 to 10%

Cons

    • There can be post operative bleeding
    • Delay in gastric emptying
    • Requirement of injecting insulin every single day after pancreatic cancer treatment

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Author

Alvina Hasan

M.Pharm

1 Year of Experience

Alvina Hasan is a dedicated medical researcher and scientific writer with a strong foundation in the pharmaceutical sciences. She holds a B.Pharm from Jamia Hamdard University and an M.Pharm in Quality Assurance from DIPSAR University. With deep medical expertise and a strong interest in healthcare communication, she focuses on transforming complex clinical and scientific information into clear, engaging, and easy-to-understand narratives. She develops insightful healthcare articles and research-driven pieces designed to support both medical professionals and patients, helping bridge the gap between advanced medical knowledge and practical understanding. . View More