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Pancreatectomy is removal by surgery of part or all of the pancreas, and often other organs that may be attached to it. The most common indications for this surgery are pancreatic cancer or recurrent bouts of severe pancreatitis. It is a difficult surgery that has long reaching complications, but it may be the only means by which certain conditions can be addressed or possibly cured.
The pancreas has several important functions. It makes enzymes that help to digest food and it also creates insulin, which is vital to regulating blood sugar levels. Diseases of the pancreas, including cancer, may affect function. Still, removal of this important part of the body has to be weighed against the side effects it will cause. People will need enzyme and insulin support if the full pancreas is removed. It isn’t always fully removed and many people undergo a partial pancreatectomy.
When pancreatectomy is performed, frequently other parts of organs may need to be removed too. These include the duodenum, spleen, parts of the intestine or stomach, and possibly the bile duct or the full gall bladder. Many pancreatectomies are part of a complicated surgery called the Whipple procedure, which reroutes the intestines after a variety of ducts or organs are at least partially removed.
As mentioned, full or partial pancreatic removal is typically only desirable when there remains little choice for other treatments. Even in situations where something like cancer is present, partial removal of the pancreas is often chosen over full pancreatectomy due to potential for side effects. On the other hand, occasionally the only chance for survival is to take out the entire organ, and even with this decision, survival rates for pancreatic cancer are not as favorable as could be hoped. Early treatment is associated with higher and lengthier survival rates, though, and aggressive treatment after early diagnosis can be preferred.
From the patient perspective, pancreatectomy is a very serious surgery that will take recovery time. Hospital stays of several weeks are expected after pancreas removal. Discomfort directly after surgery can be significant, though work with doctors can be useful to reduce this through pain medication. People may also need to take medicines that help with food digestion and insulin control.
Depending on medical condition prior to surgery, it may take a while to reestablish normal activities and those without a pancreas will need consistent medical follow-up. They usually work with gastroenterologists, but other specialists might be involved if the surgery was performed to treat cancer. In fact, if this is an initial treatment for cancer, it could be immediately followed by other treatments like chemotherapy.
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