Distal Pancreatectomy is an operation to remove the tail of the pancreas along with part of the body of the pancreas. Unlike the Whipple operation, the head of the pancreas, the duodenum, the bile duct and the stomach do not need to be removed. It is an easier operation compared to the Whipple operation.
Depending on the nature of the disease, this operation can be combined with the removal of the spleen. In selected cases, the spleen can be preserved. This technique is called the spleen-preserving distal pancreatectomy.
Advantages of preserving the spleen are:
- less complications of infection
- less haematological (blood) problems such as high platelet counts
- immune function of the spleen is preserved
This operation is performed under general anaesthesia. In addition, the anaesthetist may place an epidural catheter for epidural analgesia. This provides excellent pain relief following the surgical operation.
This operation can be done via an open cut or by using keyhole (laparoscopic) method. The laparoscopic technique is applicable even for cases where the spleen is to be preserved.
Our doctors at Nexus Surgical Digestive Disease Centre are able to perform:
- Laparoscopic distal pancreactomy with splenectomy
- Laparoscopic spleen-preserving distal pancreatectomy (Novel approach to laparoscopic resection of tumours of the distal pancreas. ANZ J Surg 79 (2009) 288–293)
- Open distal pancreatectomy with splenectomy
- Open spleen-preserving distal pancreatectomy
If you have a problem in the body or tail of the pancreas, and would like to know if an operation is needed, and what type of technique is suitable for your condition, please do not hesitate to contact us.
General information about distal pancreatectomy
Your surgeon will assess your general health status. Blood tests, chest X-ray and electro-cardiogram (ECG) may be done if needed. The purpose of these tests is to ensure that you are healthy and fit enough to proceed with the operation under general anaesthesia.
If there is a plan to remove the spleen, then your doctor will boost your immune system before the operation by giving you some vaccinations:
- Pneumococcal vaccine
- Meningococcal vaccine
- Haemophilus influenza vaccine
You may be admitted one day before the operation or on the day of their operation. You will need to fast and not eat or drink anything for 6 hours before the operation.
Your anaesthetist will put you to sleep first before we start. You will have a catheter placed into your bladder to drain the urine. A tube will also be placed through one of your nose into the stomach to empty the stomach.
The entire operation may take from 3 hours to 6 hours.
Immediately after the surgery, the patient may be sent to the High Dependency ward for one or two days.Subsequently, the patient will be nursed in the General Ward.
The patient may have a nasogastric tube and a urine catheter. In addition, there will be one to two surgical tubes placed into the abdomen to remove any residual fluid or blood.
The patient will be kept fasted for a few days. Intravenous fluid will be given to the patient for hydration as well as nutrition.
You will be encouraged to be as active as possible. Whilst in bed, you may be asked to:
- Do frequent calf and leg exercises by pointing your toes up and down. This will reduce the risk of deep vein thrombosis (DVT).
- Do deep breathing exercises and cough. This will reduce your risk of getting a chest infection.
The average length of stay following a distal pancreatectomy is 5 to 7 days. However the length of stay may vary in individuals.
If there are any complications, the length of stay will be prolonged.
Some of the risks associated with pancreatic operations can be read here.
Home care after Distal Pancreatectomy
You can read more about how to care for yourself following your discharge from the hospital after a surgical operation by clicking here.
An appointment date will be given to you to return for a follow up consultation, usually in about a week.
Please contact your Nexus Surgical surgeon at our 24-hr hotline (+65 6333 5550) if you experience the following:
- Fever more than 38oC
- Severe pain and redness at the wound site
- Discharge from the incisions such as pus and excessive bleeding
- Jaundice (yellowing of skin)
- Severe abdominal pain and bloating