A distal pancreatectomy is where the bottom half of the pancreas is removed by a surgical procedure. The most frequent reason for performing a distal pancreatectomy is the presence of a tumor in the body or tail of the pancreas.
After removal of the pancreas, the cut edge of the pancreas is often sutured to prevent leakage of pancreatic juice from this area. Most common complication of a distal pancreatectomy is leakage of pancreatic juice from the cut edge of the pancreas. Dilip Parekh M.D. has developed a specialized technique for suturing this part of the pancreas that has led to a very low incidence (less than 3%) of leakage of pancreatic juice after the surgery. This incidence is much less than what is usually reported from many of the major centers in the United States.
Different techniques are available at USC for distal pancreatectomy.
Open distal pancreatectomy and splenectomy
In this procedure the body and tail of the pancreas is removed with the spleen. The spleen is removed with the pancreas since the blood supply to the spleen is intimately associated with the pancreas. This procedure is most frequently performed in patients with adenocarcinoma of the pancreas.
Spleen preserving distal pancreatectomy
A surgical procedure is available where the spleen is preserved removing only the pancreas. USC is one of the few centers where this procedure is performed in Southern California. In this procedure the the blood vessels to the spleen that also provide blood supply to the pancreas are delicately separated from the pancreas and preserved and the tail of the pancreas is removed. This surgical procedure is indicated for patients with cystic tumors and islet cell tumors of the pancreas. This procedure is not indicated and should not be performed in patients who have adenocarcinoma of the pancreas.
Laparoscopic distal pancreatectomy
We offer laparoscopic removal of the pancreas to patients that have islet cell tumors of the pancreas or cystic tumors in the body or tail of the pancreas. selected patients with pseudocysts or chronic pancreatitis may also be suitable candidates.
During this procedure, two half inch incisions are made and a laparoscopic hand-access device is utilized to perform the surgery. The hand-access device incision is about 2 to 2.5 inches long.
Hand assisted laparoscopic surgery is a major advancement in laparoscopic surgery and allows the surgeon to place his/her hand into the abdomen during the surgical procedure.
Patient who undergo laparoscopic distal pancreatectomy have less pain, rapid recovery and early discharge from the hospital compared to open distal pancreatectomy. Our average hospital stay for this procedure is about two days compared to 4-6 days for open surgery for distal pancreatectomy.
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