Pancreatectomy (Removal of the Pancreas)

One of the frequently performed pancreatic surgeries is a pancreaticoduodenectomy — or Whipple surgery.

During a Whipple, the surgeon typically removes:

• Part of the pancreas.
• Part of the small intestine.
• All of the bile duct.
• All of the gallbladder.
• A small part of the stomach.
• Several lymph nodes.

Your surgeon will then reconnect the pancreas, stomach, and bile duct to the intestine.

There are other partial pancreas removal surgeries, but the Whipple is the most commonly recommended.

During this operation, the surgeon removes a precise part of the pancreas known as the distal portion. It's located toward the tail end of the pancreas.

Often, but not always, the surgeon will also remove the spleen.

Unlike the Whipple, a distal pancreatectomy leaves the small intestine, bile duct, gallbladder, and stomach intact.

A total pancreatectomy removes the entire organ.

This option is for highly specific and tailored circumstances, based on your medical condition.

Total pancreatectomy also includes removing all or part of other organs, such as:

• The spleen.
• The gallbladder.
• Nearby lymph nodes.
• Part of the intestine.
• Part of the stomach.

Your care team will decide what surgery is best based on the size and location of your tumors. The presence of benign or precancerous conditions is also a factor.

Removing your pancreas:

• Can extend your life or improve your quality of life.
• Can reduce pain and other health issues caused by chronic pancreatitis.
• May stop the spread of cancer throughout your body.

Pancreas removal is a complex surgery.

As with any surgery, risks include bleeding, infection, breathing, or heart problems.

Pancreas removal also carries specific risks, such as:

• Diabetes.
• Fluids leaking from the pancreas, bile duct, stomach or intestine.
• Problems emptying the stomach after surgery.
• Weight loss.

You'll meet with your surgeon and your surgical team.

They'll make sure any existing health conditions are properly managed and under control, such as:

• Diabetes.
• Heart problems.
• High blood pressure.
• Lung problems.

Your doctor will order tests before the surgery.

These might include:

• A chest x-ray.
• A CT scan.
• An electrocardiogram (EKG).
• An endoscopic retrograde cholangiopancreatography (ERCP) to check the bile and pancreatic ducts.
• Blood work, including complete blood count (CBC), electrolyte levels, liver function tests, and kidney function tests.
• Ultrasound.

Your surgeon may ask you to stop taking blood thinners before the surgery. Your care team will tell you which medicines are okay to take on the day of your surgery.

Your surgeon will ask you to stop smoking cigarettes and drinking alcohol. Quitting these habits will help with a smoother and more effective recovery.

On surgery day, let your doctor know how you're feeling. A cold, flu, fever or other illness may increase the risk of post-op complications and cause them to postpone surgery.

You won't be able to eat or drink anything for several hours before the surgery. Your doctor will give you detailed instructions.

You will be asleep during the surgery.

The doctors will give anesthesia through an IV line. You'll have a tube in your throat to help you breathe and a catheter to drain urine.

Your surgical team will work to ensure your safety and comfort while removing all or part of your pancreas.

The length of the surgery can vary depending on how complex your condition is. On average, a pancreatectomy can take anywhere from five to seven hours.

We'll admit you to the hospital for close monitoring. Based on your surgeon's assessment, you may wake up in the ICU or on a regular hospital floor.

You'll get fluids and pain medicine through your IV to manage discomfort and maintain hydration.

You may have drains in your abdomen to prevent fluid build-up. You may also have a tube in your nose to drain your stomach contents after the surgery.

Nurses will help you get out of bed and move around on the first day after surgery. This is essential for a smoother recovery.

Your care team will watch your blood sugar levels and digestion after the surgery.