Total Pancreatectomy?

A total pancreatectomy is performed to treat pancreatic cancer. The procedure involves the removal of the entire pancreas, as well as the spleen, gallbladder, common bile duct, and portions of the small intestine and stomach. By removing the pancreas, the chance of removing the entire tumor is increased. Unfortunately, a total pancreatectomy leaves the patient unable to produce pancreatic enzyme for digestion and insulin for controlling blood glucose level. The patient will be required to take supplemental enzymes and insulin for the remainder of his or her life.

What do I need to do before surgery?

Please contact your insurance company to verify coverage and determine whether a referral is required. You will be asked to pre-register with the appropriate hospital and provide demographic and insurance information. This must be completed at least five to ten days before the date of surgery. Your surgeon will give you specific instructions on how to prepare for your surgery.

What happens on the day of surgery?

You will report to a pre-operative nursing unit and will be asked to change into a hospital gown. A nurse will review your chart and confirm that all paperwork is in order. You will be taken to a pre-operative holding area and an anesthesiologist will start an IV. Before any medications are administered, your surgeon will verify your name and the type of procedure you are having. You will then be taken to the operating room. After the appropriate form of anesthesia is administered, surgery will be performed.

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What type of anesthesia will be used?

You will have a pre-operative interview with an anesthesiologist who will ask you questions regarding your medical history. A pancreatectomy is performed under general anesthesia which will keep you asleep during surgery.

What happens during the surgery, and how is the surgery performed?

The goal of a total pancreatectomy is to remove the entire pancreas and the attached organs. First, the end of the stomach is divided off and detached. This part the stomach leads to the small intestine, where the pancreas and bile duct both attach. In the next step, the pancreas is removed along with the connected section of the small intestine. The common bile duct and the gallbladder are also removed. To reconnect the intestinal tract, the stomach and the bile duct are connected to the small intestine.

Several tubes are implanted for postoperative care. To prevent tissue fluid from accumulating in the operated site, a temporary drain leading out of the body may be implanted. Also, a Gastrostomy or G-tube leading out of the stomach will help prevent nausea and vomiting, and a Jejunostomy or J-tube inserted into the small intestine will serve as a channel for supplementary feeding.

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