Pancreatectomy

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Intervention: Pancreatectomy
ICD-10 code:
ICD-9 code:	52.5 52.6
MeSH	D010180
Other codes:

This article appears to contradict itself about indication on painful conditions. Please help fix this problem. (May 2009)

In medicine, a pancreatectomy is the surgical removal of all or part of the pancreas. Several types of pancreatectomy exist, including pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy. These procedures are used in the management of several conditions involving the pancreas, such as benign pancreatic tumors, pancreatic cancer, and pancreatitis.

Contents 1 Indications 2 Types 3 Prognosis 4 External links

[edit] Indications

It is performed for a variety of reasons, including:

• Inflammation
  • Necrotising pancreatitis
  • Chronic pancreatitis with pain
• Trauma
• Neoplasms
  • Adenocarcinoma (85%)
  • Cystadenoma (mucinous/serous)
  • Cystadenocarcinoma
  • Islet cell tumors (neuroendocrine tumors)
  • Papillary cystic neoplasms
  • Lymphoma
  • Acinar cell tumors
• Severe hyperinsulinemic hypoglycemia

[edit] Types

The most common surgical procedure involving removal of a portion of the pancreas is called a pancreaticoduodenectomy.

Among common consequences of complete or nearly complete pancreatectomy are deficiencies of pancreatic endocrine or exocrine function requiring replacement of insulin or digestive enzymes. The patient immediately develops type I diabetes, with little hope for future type I diabetes treatments involving the restoration of endocrine function to a damaged pancreas, since the pancreas is either partially or completely absent. Type I diabetes can be treated with careful blood glucose monitoring and insulin therapy. Due to the fact that the Pancreas is responsible for the production of many digestive enzymes, a pancreatectomy should only be given as an option for pancreatic disease which is life threatening, such as pancreatic cancers. It is very important to note that even after a pancreatectomy, pain still exists in most patients.

A distal pancreatectomy is removal of the body and tail of the pancreas.

[edit] Prognosis

Prognosis for patients living without a pancreas is very poor. Without the endocrine enzymes (glucagon, insulin, somatostatin, and pancreatic polypeptide) or the exocrine enzymes (trypsin, chymotrypsin, pancreatic lipase and amylase) a patient would be on a lengthy regimen of medications and would be severely limited in his diet.

[edit] External links

• Endoscopic Transgastric Distal Pancreatectomy

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