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Distal pancreatosplenectomy

16. Distal pancreatosplenectomy blog
  • A distal pancreatectomy is a surgery to remove part of pancreas called body & tail. Many a times spleen is also removed along with the pancreas. If done so, the surgery will be termed as distal pancreatosplenectomy.

  • Some common indications for surgery are as follows:
    • Chronic pancreatitis (chronic and recurrent inflammation of the pancreas)
    • Pancreatic tumors
    • Stenosis (narrowing) the pancreatic duct
    • Pancreatolithiasis (calculi/stones in the pancreas)
    • Pancreatic cysts
    • Pancreatic trauma

A spleen may be removed during the surgery because the artery supplying the spleen lies along the body and tail of the pancreas. Because of this, the blood vessel can get blocked, and infection or tumor can spread to the spleen.

Because the spleen helps the body fight infection, a splenectomy (spleen removal) would reduce the patient’s immunity. Hence, the doctor would recommend certain vaccines before the surgery and precautions to be taken after the surgery.

Recovery after the surgery usually takes around five to seven days. In extensive surgery for advanced or complicated tumours, the recovery might take longer. The drainage tube is watched for the content plus amount and removed when appropriate.

In a few patients, the recovery will not be smooth and there will be a deviation from the expected postoperative course. This is described as a complication. There can be bleeding, infection and intra-abdominal collection. The cut end of the pancreatic duct can leak, a condition identified as pancreatic fistula. Most of these complications are manageable but may result in prolongation of hospital stay.

At the time of discharge, most patients are eating a normal diet and can carry out activities of daily living. Depending on the type and stage of the tumour, you might be advised further chemotherapy or radiotherapy called adjuvant treatment. In the long term, some of the patients may develop indigestion due to pancreatic enzyme insufficiency or diabetes due to deficiency of hormones.

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Dr. Harsh J Shah

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