What is pancreatectomy surgery?

Pancreatectomy is the surgical removal of all or part of the pancreas, used to treat conditions such as pancreatic tumors, cysts, and chronic pancreatitis.

What are the different types of pancreatectomy?

Common types include distal pancreatectomy (removing the body and tail), pancreaticoduodenectomy or Whipple procedure (removing the head), central pancreatectomy, and total pancreatectomy.

What conditions are treated with pancreatectomy?

It is indicated for pancreatic ductal adenocarcinoma, benign cystic tumors, neuroendocrine neoplasms, chronic pancreatitis, and severe trauma to the pancreas.

What are the surgical approaches for a pancreatectomy?

Surgeries can be performed using an open approach, laparoscopically, or through robot-assisted techniques, depending on the patient's condition and the tumor's location.

What are the potential complications of pancreatic surgery?

Potential complications include pancreatic fistula, hemorrhage, wound infection, and endocrine or exocrine insufficiency, such as diabetes.

Pancreatectomy Surgery in Singapore

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Pancreatectomy Surgery in Singapore

Most pancreatectomy surgery procedures are performed to treat pancreatic tumours or cancers. There are a select group of patients with chronic inflammation of the pancreas who may benefit from total pancreatectomy to relieve their chronic abdominal pain.

Pancreatectomy Definition

Pancreatectomy is a potentially curative option in the treatment of pancreatic cancer. With this procedure, the pancreas is partially or entirely removed. Total pancreatectomy surgery involves the removal of not only the pancreas but also parts of other organs, including the stomach, gallbladder, intestine, spleen, biliary duct, and some lymph nodes. On the other hand, partial pancreatectomy refers to the removal of certain parts of the pancreas such as the tail (distal pancreatectomy), head (Whipple procedure), or body (median pancreatectomy).

Types of Partial Pancreatectomy

A partial pancreatectomy can be classified into several types, depending on the extent of the pancreatic disease. The main types of partial pancreatectomy include:

Distal Pancreatectomy.

Removes the tail and part of the body of the pancreas. It is often performed to treat tumours located in the tail of the pancreas

Pancreaticoduodenectomy (Whipple Procedure)

Removes the head of the pancreas, part of the duodenum, gallbladder, and bile duct. It is commonly used to treat pancreatic cancer in the head of the pancreas.

Median Pancreatectomy

This refers to the removal of the middle portion of the pancreas to target lesions or tumours in the body of the pancreas. It is more complex than distal or pancreaticoduodenectomy and it carries a higher risk of complications.

Prognosis Following Pancreatectomy

Pancreatectomy is a major surgery, associated with significant morbidity/complication ranging from 30-60% chance even in the best surgical centres in the world. Distal pancreatectomy is associated with 1-3% mortality, while Whipple procedure is associated with 3-5% mortality. The important considerations are that the decision for pancreatectomy surgery is well-discussed and risks/benefits are well explained. Such operations have better outcomes with high-volume pancreatic centres or surgeons. Despite the surgical risks, pancreatectomy remains the only potentially curative option for patients with pancreatic cancer.

Possible Complications of Pancreatectomy Surgery

Pancreatectomy surgery is done to remove cancerous pancreatic tissue, but it can result in mild to severe complications, which can lead to death.

The complications resulting from pancreatectomy surgery depend on which part or which tissues of the pancreas are removed. Such complications can include the following:

Haemorrhage or Bleeding

During pancreatectomy, the surgeon must carefully dissect and remove the affected portion of the pancreas, taking care to avoid nearby blood vessels. While bleeding can occur if a vessel is accidentally damaged, a skilled surgeon will manage such situations promptly.

Additionally, coagulopathy, a temporary blood clotting issue that may arise during surgery, can increase the risk of bleeding. Rest assured, your surgery team will take precautions to minimise this risk and monitor for any signs of bleeding throughout the procedure.

Pancreatic Fistula

This can occur with either the Whipple procedure or distal pancreatectomy. Pancreatic fistula occurs when pancreatic tissue heals poorly after surgery, resulting in leakage of pancreatic fluid into the abdomen. If the fistula is uncontrolled, it can lead to shock and organ failure. The majority of pancreatic fistula will heal over time, usually over several weeks.

Wound Infection

In addition, the entire removal of the pancreas can cause digestive and endocrine disorders such as difficulty in digestion, weight loss, diarrhoea (loose stools), and diabetes. Doctors will usually prescribe medication post-pancreatectomy procedures in the event of these symptoms.

As the pancreas is responsible for the secretion of some digestive enzymes, surgery of the pancreas may be associated with leakage of enzymatic juice, causing digestion or injury of other surrounding tissues and organs.

Are you considering pancreatectomy? Our pancreas surgeons Dr Victor Lee and Dr Tan Ek Khoon, can provide personalised guidance and support. Schedule a consultation to discuss your specific situation and explore your options.

Pancreatectomy Surgery in Singapore

Pancreatectomy Surgery in Singapore

Pancreatectomy Definition