Tumours from the hormone producing cells are pancreatic neuroendocrine tumours. The position of the pancreas in the back of the abdomen and its relationship to the major blood vessels, the small intestine and the liver, mean that all pancreatic surgery is major and complex.
A complete pancreatectomy that removes the entire pancreas also requires the removal of parts of the stomach, a portion of the small intestine called the duodenum, and the end of the bile duct. The gallbladder and the spleen may be removed as well. This extensive surgery can be dangerous and life-changing.
It carries a relatively high risk of complications that can be life threatening. When the operation is done in small hospitals or by doctors with less experience, as many as 15% of patients may die as a result of surgical complications.
The procedure takes 4-12 hours. Recovery in the hospital can last 7-14 days. Healing at home takes about 2 weeks. You can return to normal life after 4-6 weeks.
Whipple Surgery
This highly technical surgery removes the front end of the pancreas (part that attaches to the intestine). Surgeons also remove other tissues, such as the gallbladder and sections of bile duct, small intestine and stomach, as necessary.
Those who undergo a successful Whipple procedure may have a five-year survival rate of up to 25%. The classic Whipple procedure is named after Allen Whipple, MD, a Columbia University surgeon who was the first American to perform the operation in 1935.
Heavy lifting, straining, and exercise should also be paused for up to 6 – 8 weeks, or until your surgeon has deemed these activities safe and appropriate. For most patients, full recovery after pancreas surgery takes about 1 – 3 months.
Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation. For about 4 to 6 weeks after surgery, avoid lifting anything that would make you strain.
Patients reported a decrease in physical, social and global scales within the first 3 months after surgery. These values showed improvement and were comparable to baseline values by 6 months. Recovery in emotional functioning towards baseline figures was demonstrated in the first 3 months post-operatively.
You may have lost your appetite, or feel full quickly. Eating smaller meals may help. The pancreas plays an important role in breaking down (digesting) food. Removing all or part of the pancreas may affect how well you can digest food and may cause symptoms such as weight loss, diarrhoea, tummy discomfort or bloating.
The conventional operation is a pancreaticoduodenectomy which carries a mortality risk of 3-7%. We used the National Cancer Database (NCDB) to examine surgical outcomes following pancreatectomy.
The most common complications following pancreatic surgery are pancreatic fistula (pancreatic fistula), haemorrhage, pancreatitis, porto-mesenteric venous thrombosis, delayed gastric emptying and anastomotic strictures.
There is no doubt that the Whipple procedure is a painful operation. This is largely due to the extent of the organs being removed or rearranged and the proximity of the pancreas to nerves as they exit the spine at the back of the abdomen during the operation.
For cancer in the body or tail of the pancreas
You might have surgery to remove the body and tail of your pancreas. It is called a distal pancreatectomy. Very rarely, your surgeon might plan to remove the whole pancreas.
This is known as adjuvant chemotherapy. You might have chemotherapy after surgery to lower the risk of the cancer coming back. You have adjuvant chemotherapy for up to 6 months. It should start within 3 months of having surgery.
Short-term post-surgical nutritional guidelines:
Start oral diet with clear liquids and advance to solid foods. Eat small, frequent meals. Avoid greasy and fried foods. Limit consumption of raw fruits and vegetables, initially.
Avoid foods high in insoluble fiber, such as whole grains, as many find them hard to digest immediately after surgery. Until your system settles down, eat “white” foods, such as white rice, pasta, bread, and crackers. And peel all fruits and vegetables.
This usually involves admission to hospital so you can be given fluids into a vein (intravenous fluids), as well as pain relief, nutritional support and oxygen through tubes into your nose. Most people with acute pancreatitis improve within a week and are well enough to leave hospital after 5-10 days.
Weight gain was reported in 22 patients (28.6%), 86.4% reported to be unintentional. Weight loss was most frequently observed among total pancreatectomy (72.7%) and pancreatoduodenectomy (64.9%) patients, and least likely among central pancreatectomy (30.0%) patients.
Due to improved perioperative intensive care, medical complications such as myocardial, pulmonary and thromboembolic problems have dramatically decreased 18. The postoperative medical complication rate is in the order of 4%–19% 25.
Before continuing, your surgeon needs to make sure the cancer has not spread and that the tumor is still operable. Your surgeon removes the cancerous part of your pancreas, and if necessary, the spleen. The surgery takes between three to four hours.
Prognosis in acute pancreatitis
Patient outcomes are often very positive and people usually make a full recovery. Alcohol intake should be eliminated, even in cases where alcohol was not the cause of the condition.
Background: Mortality in chronic pancreatitis is higher than in the general population, the 10-year survival after diagnosis is estimated between 69-80%.
Chronic pancreatitis can affect people of any age, but is most common in middle-aged men aged between 45 and 54.