A laparoscopic distal pancreatectomy is a minimally invasive surgical procedure that is performed to remove benign or malignant (cancerous) tumors in the body or the tail of the pancreas. The surgeon most often will need to remove the spleen because it is located near the pancreas and shares some of the blood vessels.
What Should I Expect From a Laparoscopic Distal Pancreatectomy?
- You receive general anesthesia, meaning you will be asleep for the procedure.
- Your abdomen is filled with gas to expand the area and allow your surgeon to see the abdominal cavity better.
- Your surgeon inserts a tube through your nose and into your stomach to prevent nausea and vomiting. Your surgeon also inserts drainage tubes to aid with drainage of fluids that are produced during surgery and recovery.
- Your surgeon makes three small incisions. The first is for a small camera that allows your surgeon to see the pancreas and surrounding area; the second is for surgical instruments; and the third is for your surgeon's hand.
- Before continuing, your surgeon needs to make sure the cancer has not spread and that the tumor is still operable.
- Your surgeon removes the cancerous part of your pancreas, and if necessary, the spleen.
- The surgery takes between three to four hours.
What is Recovery Like After a Laparoscopic Distal Pancreatectomy?
You will need to stay in the hospital for three to five days. You will have an IV tube in your vein so you can receive fluids and medication. Here's what happens next:
- Immediately following surgery, you are in the Post Anesthesia Care Unit (PACU) to be monitored for a few hours.
- Once you are stable, you are transferred to a regular surgical floor; if your surgeon feels you need extra monitoring, you may be moved to another unit in the hospital.
- For the first day or two, you receive pain medication through a patient controlled analgesia (PCA) pump, which puts you in charge of delivering your pain medication. Then, you are taken off the pump and can receive pain medications by injection or by mouth.
- The tubes inserted during surgery, both to control vomiting and to drain fluids, are removed when the doctor feels it is appropriate. Sometimes, you may go home with the drainage tubes; if this is the case, you will receive detailed instructions on how to manage them before you are discharged.
- You will receive insulin to regulate your blood sugar and promote healing.
- At first, you will not be able to eat regular food. After two to three days, you can begin on clear liquids and then advance to other foods slowly.
- You can begin to resume some activity one day after surgery; you start by sitting up in a chair and walking. You may take a shower 24-48 hours after surgery, unless your doctor tells you differently.
- Vaccines are recommended if you underwent a splenectomy, because the spleen plays an important role in the immune system. You will need extra vaccines to help fight infections.
Before you leave the hospital, you will receive detailed discharge instructions that cover the following:
- Pain management
- Incision care
- Resuming activities (you can usually resume your full activity level four to six weeks after surgery)
- Follow-up appointments
- Receiving help at home
- Recovery time
Complications from a Laparoscopic Distal Pancreatectomy are minimal, but may include:
- A fistula (leak): This may occur if the sutures (stitches) fail to seal properly. You may require intravenous feeding until the tissue heals.
- Weight loss: This is common, but you will regain some of the weight as you begin to increase your food intake.
- Diabetes: This may occur if you have a family history of diabetes or you are pre-diabetic. The pancreas is responsible for releasing insulin, which controls blood sugar. So, the removal of part of your pancreas affects your blood sugar level.
- Pancreatic enzyme insufficiency: If this occurs, you may require pancreatic enzyme replacement therapy.
Call your doctor if you have:
- Fever greater than 100.4
- Increased or foul-smelling drainage from your incision
- Increased pain or redness at the incision site
- Pain, nausea or vomiting
- Diarrhea or constipation