Pancreaticoduodenectomy
Pancreatectomy sometimes entails removal of the entire pancreas, called a total
pancreatectomy, but more often involves removal of part of the pancreas, which is called a
subtotal pancreatectomy, or distal pancreatectomy, when the body and tail of the pancreas
are removed. When the duodenum is removed along with all or part of the pancreas, the
procedure is called a pancreaticoduodenectomy, which surgeons sometimes refer to as
"Whipple's procedure." Pancreaticoduodenectomy is being used increasingly for
treatment of a variety of malignant and benign diseases of the pancreas.
Regional lymph nodes are usually removed during pancreaticoduodenectomy. In distal
pancreatectomy, the spleen may also be removed.
Pancreatectomy is the most effective treatment for cancer of the pancreas
Pancreatectomy is the most effective treatment for cancer of the pancreas, an abdominal
organ that secretes digestive enzymes, insulin, and other hormones. The thickest part of
the pancreas near the duodenum (small intestine) is called the head, the middle part is
called the body, and the thinnest part adjacent to the spleen is called the tail.
While surgical removal of tumors in the pancreas is preferred, it is only possible in
the 10-15% of patients who are diagnosed early enough for a potential cure. Patients who
are considered suitable for surgery usually have small tumors in the head of the pancreas
(close to the duodenum, or first part of the small intestine),have jaundice as their
initial symptom, and have no evidence of metastatic disease (spread of cancer to other
sites).
Other reasons a Pancreaticoduodenectomy is performed
Pancreatectomy is sometimes necessary when the pancreas has been severely injured by
trauma, especially injury to the body and tail of the pancreas. While such surgery removes
normal pancreatic tissue as well, the long-term consequences of this surgery are minimal,
with virtually no effects on the production of insulin, digestive enzymes, and other
hormones.
Chronic pancreatitis is another condition for which pancreatectomy is occasionally
performed. Chronic pancreatitis--or continuing inflammation of the pancreas that results
in permanent damage to this organ--can develop from long-standing, recurring episodes of
acute (periodic) pancreatitis. This painful condition usually results from alcohol abuse
or the presence of gallstones. In most patients with alcohol-induced disease, the pancreas
is widely involved, therefore, surgical correction is almost impossible.
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