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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. In total pancreatectomy, the gallbladder, distal stomach, a portion of the small intestine ...
It can, therefore, be performed only in a minority of cases. Cancers of the tail of the pancreas can be resected using a procedure known as a distal pancreatectomy, which often also entails removal of the spleen. [2] [3] Nowadays, this can often be done using minimally invasive surgery. [2] [3]
The most common technique of a pancreaticoduodenectomy consists of the en bloc removal of the distal segment (antrum) of the stomach, the first and second portions of the duodenum, the head of the pancreas, the common bile duct, and the gallbladder. Lymph nodes in the area are often removed during the operation as well (lymphadenectomy).
Histopathology of IPMN types in a distal pancreatectomy specimen from a 60-year-old man, by gross pathology (center image), microscopy and immunohistochemistry: The resected specimen (c) revealed that the mural nodule in the MPD consisted of PB-type IPMN with high-grade dysplasia (adenocarcinoma) (a) with a diffuse positivity of p53 immunostaining (an insert) and KRAS mutation (G12V).
Surgery can include the removal of the head of the pancreas (a pancreaticoduodenectomy), removal of the body and tail of the pancreas (a distal pancreatectomy), or rarely removal of the entire pancreas (a total pancreatectomy). [6] In selected cases the surgery can be performed using minimally invasive techniques such as laparoscopy. [7]
Exocrine pancreatic insufficiency. Exocrine pancreatic insufficiency (EPI) is the inability to properly digest food due to a lack of digestive enzymes made by the pancreas. EPI is found in humans affected by cystic fibrosis and Shwachman–Diamond syndrome. It is caused by a progressive loss of the pancreatic cells that make digestive enzymes.
The type of surgery depends on the degree of the injury and its proximity to the mesenteric blood vessels that serve the pancreas. When injuries are not close to the mesenteric vessels, a distal pancreatectomy may be done; this procedure preserves much of the pancreas and usually avoids loss of its endocrine and exocrine functions. [4]
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