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Pancreatic Surgery

Anatomy and pancreatic surgery

The pancreas is a 6-inch gland located between your spine and your stomach, surrounded by the intestine and liver. Hormones are produced by the pancreas including insulin. The hormones help the body use food energy. The pancreas also produces enzymes the help digest food and are released through a bile duct into the small intestine.

Symptoms and conditions

Symptoms that may indicate a problem with the pancreas include:

  • persistent abdominal pain in the upper left or upper middle abdomen
  • pain that is worse when lying flat on the back
  • pain that is worse within minutes after eating or drinking
  • anxiety
  • fever
  • nausea or vomiting
  • sweating

Disorders of the pancreas are usually caused by a tumor resulting from pancreatic cancer, or inflammation from chronic pancreatitis. Pancreatitis can also be caused by gallstones, pebble-like deposits that form inside the gallbladder and can block the pancreatic duct as they pass through the intestine.

While many people who have chronic pancreatitis recover from the inflammation, in others it can destroy pancreatic tissue causing part of the pancreas to die. Patients who abuse alcohol or smoke often can experience pancreatitits. In other patients the condition occurs without reason, developing over many years.

Pancreatic surgery procedure

When gallstones cause pancreatitis the pancreatitis may go away once the gallstone passes further into the lower intestine. But when a gallstone blocks the pancreatic duct where the pancreas drains into the lower intestine, the gallstone may need to  be removed with a minor surgical procedure using endoscopy. The endoscope, a lighted tube with a TV camera on the end, is inserted into the patient's mouth and esophagus. The endoscope goes through the stomach and small intestine. When the surgeon sees the pancreatic duct, he uses a surgical instrument on the endoscope to remove the gallstone.

Very rarely pancreatitis is severe enough to require surgery, which is usually performed when the pancreas becomes infected. Dead pancreatic tissue is removed, and the area around the pancreas is washed clean. Patients who require such treatment usually have prolonged hospital stays and are seriously ill.

Surgery for pancreatic cancer is a major operation that requires removing part or all of the pancreas. Patients need to stay in the hospital for several days afterward.

After pancreatic surgery

  • Several days after surgery the patient can go home. You may feel weak and must stay at home for up to one month. Recovery time can vary by patient.
  • Pain may be felt for a few days following surgery, requiring medicine to manage it.
  • A liquid diet, or intravenous feeding, may be used for several days until solid foods can be added to your diet.
  • Patients who have part of their pancreas removed may have difficulty digesting foods. A special diet may help. Side effects can include cramping, diarrhea, and feelings that you are full. 

Because the pancreas produces insulin and the enzymes and hormones that your body needs for digestion, removing part or all of your pancreas can decrease the amounts your body needs. Diabetes results from not having enough insulin. The doctor may need to prescribe supplements for insulin, hormones and enzymes.

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