Laparoscopic Pancreatic Surgery in Singapore

What Is a Diagnostic Laparoscopy?

Pancreas cancer is likely to disseminate to other tissues and organs as it progresses to later stages. The pancreas cancer surgeon will need to identify the extent of cancer dissemination accurately. This may require utilising the diagnostic laparoscopy technique. Based on the pancreas examination and diagnostic test results, the surgeon will decide the type of surgery best for the patient’s pancreas cancer stage and condition.

Commonly performed Laparoscopic pancreatic surgeries include the following:

Laparoscopic distal pancreatectomy Pancreatectomy refers to the removal of the pancreas. Depending on how much of the pancreas is affected, the surgeon will determine how much needs to be removed. Laparoscopic distal pancreatectomy is the surgery of choice in cases of pancreatic cysts, neuroendocrine tumours, and cancer, localised in the body or tail of the pancreas.

Laparoscopic enucleation of pancreatic nodule (islet cell tumours) Some pancreatic nodules may be suitable for enucleation if they are benign and located away from the pancreatic duct. This procedure preserves most of the pancreatic tissue. Typically, this can be done for insulinoma (pancreatic islet cell tumours).

Pancreatic pseudocysts (drainage procedure) Severe acute pancreatitis can cause pancreatic fluid leaks. This can result in the formation of fluid-filled growths that may obstruct the stomach and cause vomiting. For such cases, laparoscopic pancreatic surgery (pancreatic cystogastrostomy) may help drain the pancreatic fluid.

Necrotising pancreatitis Patients with necrotising pancreatitis may require debridement or removal of dead pancreatic tissue. This can be done laparoscopically and is preferred as it is less invasive. Repeated procedures may be necessary till sufficient non-viable pancreatic tissue is removed.

Are there any complications associated with pancreatic cancer surgery?

Two potential post-operative complications of pancreatic surgery are pancreatic leak and diabetes. Pancreatic leaks are not always avoidable but are best managed by an experienced pancreatic surgeon. Uncontrolled pancreatic leaks may be life-threatening and result in fever, abdominal abscess, and wound problems. Some patients may develop diabetes after pancreatic surgery. This will depend on the extent of surgery and may occur after Whipple surgery, where most insulin-producing cells are located.