Though a medical diagnosis that requires pancreas surgery can be frightening, many experienced surgeons and facilities help people with successful procedures every day. Let our experts at Arizona Premier Surgery explain the available options so you understand them. You’ll learn about recovery times, success rates, and what reduces recurrence rates.
Types of Pancreas Surgery
Typically, patients requiring pancreatic surgery have received a diagnosis of cancer or a tumor in the pancreas. Depending upon the extent of involvement, if the physicians feel they can successfully remove all of the growth, there are a few options for resection surgery.
Pylorus-Preserving Pancreaticoduodenectomy
Pylorus-preserving pancreaticoduodenectomy (PPPD) is a surgical procedure primarily utilized for treating tumors located within the pancreatic head, distal bile duct, or periampullary region.
During PPPD, the surgical team removes:
- The head of the pancreas
- The duodenum (first part of the small intestine)
- Gallbladder
- Part of the bile duct
Unlike conventional pancreaticoduodenectomy, PPPD aims to conserve the pyloric valve that regulates the passage of food from the stomach to the small intestine.
Kausch Whipple Surgery
While PPPD spares the pyloric valve, a Kausch Whipple operation, commonly known as Whipple’s operation, involves the removal of a portion of the stomach in addition to the structures removed during PPPD. Performing a Whipple procedure demands considerable skill and expertise from the surgeon. It is a highly intricate operation associated with a relatively elevated risk of life-threatening complications.
Kausch Whipple pancreas surgery entails the removal of the head of the pancreas, sometimes extending to the body of the pancreas. Adjacent structures, such as a segment of the small intestine, part of the bile duct, gallbladder, lymph nodes, and occasionally, a part of the stomach, are also excised. Following removal, the surgeon reconnects the remaining pancreas and bile duct to the small intestine to ensure the flow of digestive enzymes and bile.
Distal Pancreatectomy
In distal pancreatectomy, the surgeon removes the body and tail of the pancreas. This procedure often requires the removal of the spleen due to its proximity to the pancreatic tail and the potential involvement of its blood vessels.
Total Pancreatectomy
Total pancreatectomy involves the complete removal of the pancreas and may excise adjacent organs such as a portion of the small intestine, stomach, gallbladder, bile duct, spleen, and nearby lymph nodes.
Each pancreas surgery varies in the extent of pancreatic tissue removal and the associated risks and benefits. PPPD, Kausch Whipple, distal pancreatectomy, and total pancreatectomy serve distinct purposes based on the location and extent of the pancreatic pathology. Of these procedures, the most common by far is Whipple surgery. There are several ways that surgeons may approach this procedure.
Approaches To Whipple Surgery
Many patients undergoing Whipple surgery have been diagnosed with cancer. Decisions regarding the various methods through which a surgeon can perform the Whipple procedure are highly individualized for each patient, their diagnosis, and the stage of the disease. Factors such as prior pancreatic surgery history and the tumor’s location in relation to adjacent vessels all contribute to this decision. The following are some of the options that physicians may choose.
Open Surgery
In an open procedure, the surgeon makes an incision down the center of the abdomen to access the pancreas. This allows the surgeon a complete view and access to the tumor and organ. This method is the most common. Ninety-day mortality rates for open surgery are approximately 3.7%.
Laparoscopic Surgery
Laparoscopic surgery is a form of minimally invasive pancreas surgery. The surgeon creates small incisions in the abdomen to insert specialized instruments and a camera. The camera enables visualization of the pancreas and surrounding tissue, facilitating the execution of the Whipple procedure with the inserted instruments. Studies show that this procedure has a 90-day mortality rate of 2.8%.
Robotic Whipple Surgery
Another form of minimally invasive surgery, robotic Whipple surgery, involves making small incisions in the abdomen to insert instruments and a camera. These instruments are then linked to a robotic device controlled by the surgeon via hand controls. The robotic system allows for more precise and smaller incisions during the Whipple procedure. When conducted in specialized cancer centers by surgeons proficient in the procedure, there is 1.9% patient mortality rate within 90-days.
Considerations Before Undergoing Pancreas Surgery
Patients and healthcare providers must thoroughly discuss the indications, potential benefits, and risks associated with each pancreatic surgery. Consideration should include factors such as tumor characteristics, patient’s overall health, and post-operative quality of life.
Recovery and Post-Operative Care
Following pancreatic surgery, diligent post-operative care is essential for optimal recovery. Patients may undergo nutritional counseling, pain management, and close monitoring for potential complications such as pancreatic fistula, infection, or delayed gastric emptying. The average Whipple surgery lasts up to six hours. Post-operative hospital stays typically last for one to two weeks following the Whipple or robotic Whipple surgery and six to eight weeks once they are home.
Potential Complications and Risks
While pancreatic surgery can offer curative potential for certain conditions, it also carries inherent risks. Complications such as pancreatic leakage, hemorrhage, infection, and delayed gastric emptying may necessitate additional interventions and prolonged hospitalization.
Recurrence Rates
Studies and clinical trials show that there is a 66% to 80% chance of recurrence of cancer after pancreas surgery. However, if a tumor is resectable (stage I and stage II), the patient has a better prognosis, particularly when combined with adjuvant chemotherapy. With an experienced surgeon, even a stage III tumor may be able to be removed.
Arizona Premier Surgery Is Patients’ Top Choice for Pancreas Surgery
A diagnosis of pancreatic cancer or a pancreatic tumor is concerning enough without having to worry about finding a facility that is experienced in pancreas surgery. Arizona Premier Surgery in Scottsdale, AZ, offers several options.
APS surgeons have experience with many types of surgeries, including robotic Whipple surgery, and have high success rates. In many cases, our expert surgeons may be able to remove your cancer and preserve normal digestive flow and function using the Whipple procedure. If you are facing surgery, reach out to our team today to learn your options.
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