Pancreatectomy
What is Pancreatectomy ?
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Why do you need Pancreatectomy ?
Pancreatectomy is indicated for:
- Pancreatic cancer:
- Pancreatic ductal adenocarcinoma (90% of pancreatic cancers; 1–2 per 100,000 in India).
- Stages I–III (5-year survival: 20–40% for resectable cases; 5–10% overall due to late diagnosis).
- Neuroendocrine tumors (e.g., insulinomas, 5–10% of pancreatic tumors).
- Benign conditions:
- Chronic pancreatitis (severe, unrelenting pain or complications; 5–10% need surgery).
- Pancreatic cysts (e.g., IPMN, mucinous cysts with malignant potential).
- Trauma (e.g., pancreatic injury from accidents, rare).
- Associated treatments:
- Often preceded by neoadjuvant therapy (chemo/radiation) for borderline resectable cancer.
- Lymph node dissection and vascular resection (e.g., portal vein) for cancer staging.
- Timing:
- Performed in adults (average age 60–70 years for cancer); urgency depends on diagnosis (e.g., immediate for trauma).
The procedure aims to remove diseased tissue, prevent cancer spread, and manage symptoms, often using open or minimally invasive techniques, with significant post-op lifestyle adjustments due to pancreatic function loss.
Why Do Pancreatectomy Costs Vary in Philippines?
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Pancreatectomy Procedure
- Before Surgery Evaluation:
- Assessment:
- Imaging: CT/MRI to assess tumor size, location, and vascular involvement (e.g., SMA, SMV).
- Endoscopic ultrasound (EUS): Biopsy and staging.
- Blood tests: CA 19-9 (tumor marker), liver function, clotting profile; blood sugar levels.
- Preparation: Nutritional optimization (patients often malnourished); manage diabetes pre-op.
- Consent: Risks, including diabetes, are explained.
- Assessment:
- Surgical Techniques:
- Pancreatectomy:
- Performed under general anesthesia, lasting 4–8 hours.
- Types:
- Pancreaticoduodenectomy (Whipple procedure): Removes head of pancreas, duodenum, part of stomach, gallbladder, and bile duct; for tumors in pancreatic head (60–70% of cases).
- Distal pancreatectomy: Removes body/tail of pancreas, often with spleen; for tumors in body/tail.
- Total pancreatectomy: Removes entire pancreas; for extensive cancer or multifocal disease.
- Approaches:
- Open surgery: Large incision (15–25 cm) in abdomen; for complex cases or vascular resection.
- Laparoscopic/robotic: 4–5 small incisions (5–10 mm); camera and instruments used; for early-stage or distal resections.
- Process:
- Pancreas resected; nearby lymph nodes removed for cancer staging.
- Reconstruction (Whipple): Bile duct, pancreas, and stomach reconnected to small intestine (Roux-en-Y).
- Spleen preservation (distal): Preferred unless involved.
- Closure: Sutures/staples; drains placed to prevent fluid buildup.
- Intraoperative Tools:
- Endoscopic ultrasound: Confirms margins intra-op.
- Staplers: Divides pancreas and reconstructs.
- Harmonic scalpel: Controls bleeding.
- Pancreatectomy:
- After Surgery:
- Hospital stay: 7–14 days.
- Care: ICU for 1–3 days; nasogastric (NG) tube for 3–5 days; feeding tube (jejunostomy) for nutrition.
- Pain management: Moderate to severe pain for 5–7 days; managed with epidural or IV painkillers.
- Instructions: Monitor blood sugar (diabetes risk); pancreatic enzyme supplements for digestion.
Recovery After Pancreatectomy
- Hospital Stay: 7–14 days.
- Post-Surgery Care:
- Pain/Swelling: Moderate pain for 5–7 days; resolves in 2–3 weeks.
- Nutrition: Feeding tube for 2–4 weeks; oral intake (liquids) starts at 3–5 days; soft diet by 4–6 weeks.
- Blood sugar: Monitor closely; insulin often needed (50–70% develop diabetes after Whipple; 100% after total).
- Digestion: Pancreatic enzyme supplements (e.g., Creon) lifelong to aid fat absorption.
- Activity: Avoid strenuous activity for 6–8 weeks; light walking within 3–5 days to prevent clots.
- Follow-Up:
- Visits at 1 week (check healing), 1 month, and every 3 months for 2 years (cancer recurrence risk).
- Imaging: CT at 3–6 months to monitor for recurrence; blood sugar and CA 19-9 ongoing.
Most resume normal activities in 6–8 weeks; full recovery takes 3–6 months. Success rate: 5-year survival for resectable pancreatic cancer is 20–40%; 60–80% for neuroendocrine tumors.
Risks and Complications
- Surgical Risks:
- Bleeding (3–5%): During surgery; may need transfusion.
- Infection (5–10%): Wound or intra-abdominal; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to general anesthesia; rare in healthy patients.
- Post-Surgery:
- Pancreatic fistula (10–20%): Leakage of pancreatic fluid; may need drainage or reoperation.
- Delayed gastric emptying (10–15%, Whipple): Stomach takes time to empty; managed with NG tube.
- Diabetes (50–100%): From loss of insulin production; insulin therapy required.
- Malabsorption (20–30%): Fat malabsorption; managed with enzyme supplements.
- Long-Term:
- Recurrence (50–80%): Cancer return; needs regular monitoring.
- Nutritional deficiencies (10–20%): Vitamin deficiencies; needs supplements.
Report fever, severe pain, persistent vomiting, or uncontrolled blood sugar promptly.
Frequently Asked Questions (FAQs)
What causes the need for pancreatectomy?
Pancreatic cancer, chronic pancreatitis, pancreatic cysts, or trauma.
Can I avoid pancreatectomy?
Yes, if early: Endoscopic drainage for cysts or pain management for pancreatitis; surgery needed for cancer or severe cases.
Is pancreatectomy painful?
Moderate to severe pain for 5–7 days, managed with medication; resolves in 2–3 weeks.
How soon can I resume normal activities?
Light activities: 2–3 weeks; full recovery: 3–6 months; avoid strenuous activity for 6–8 weeks.
Is pancreatectomy covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, persistent vomiting, or uncontrolled blood sugar.
Will I need insulin after surgery?
Likely: 50–70% after Whipple; 100% after total pancreatectomy; monitor blood sugar closely.
Lifestyle changes post-surgery?
Take enzyme supplements, monitor blood sugar, eat small frequent meals, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Pancreatectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.