Total pancreatectomy surgery in Turkey : Advanced treatment options

Pancreatic cancer: What to do?

The pancreas, located behind the stomach, is an important gland for digestion and blood sugar regulation. Cancer of the pancreas develops in its tissues and most commonly manifests as adenocarcinoma, a type of cancer that originates in the cells of the pancreatic ducts.

Due to the lack of early symptoms, diagnosis is often made at an advanced stage, making treatment more complex.

Total pancreatectomy is a radical surgical procedure that may be proposed when the cancer has invaded the entire pancreas or when digestive reconstruction after removal is considered too risky

Total pancreactomy: Objectives of surgery

Pancreas removal surgery is often considered in the treatment of pancreatic cancer. The type of surgery, mainly total pancreatectomy, is chosen according to the location and extent of the tumor, and its resectability as assessed by doctors in Turkey.

The goals of surgery are manifold:

• Curative resection: completely remove the tumor if it is localized and has not spread to other organs.
• Symptomatic relief: to reduce pain and improve quality of life when the tumor is advanced (palliative surgery).

Preoperative evaluation, although thorough, does not always allow us to determine with certainty the exact extent of the tumor before surgery. At the time of surgery, the surgeon may discover that the tumor is inoperable or has spread beyond the originally planned boundaries. In this case, palliative surgery is preferred to relieve symptoms associated with obstruction of the bile ducts or intestines.

Pancreatic surgery is a complex procedure, performed by hepatobiliopancreatic (HPB) surgeons in experienced centers. These procedures may be combined with other treatments, such as chemotherapy or radiation, before or after surgery.

Course of total pancreatectomy surgery in Turkey

Total pancreatectomy is a major surgical procedure reserved for the most advanced cases of pancreatic cancer where the tumor has invaded the entire organ. This surgery involves the complete removal of the pancreas and surrounding organs (duodenum, pylorus, part of the common bile duct, gallbladder, sometimes the spleen and lymph nodes).

Digestive reconstruction is then performed to allow digestive functions to continue. This involves reconnecting the stomach and remaining bile duct to the jejunum.

Surgery to remove the entire pancreas systematically leads to the onset of type 1 diabetes, requiring lifelong treatment with insulin.

Possible side effects of total pancreatectomy

A total pancreatectomy is a major surgical procedure, and like any complex surgery, it can lead to various short-term and long-term side effects. Understanding these effects is essential to manage them effectively and support a smooth recovery.

The most common side effects include:

• Postoperative pain and discomfort.
• Surgery related complications: Infection, bleeding, leaking stitches, and blood clots.
• Digestive problems:
  • Delayed gastric emptying: feeling of rapid satiety, nausea, vomiting.
  • Dumping syndrome: headache, dizziness, sweating, diarrhea occurring rapidly after meals.
  • Malabsorption: Weight loss, diarrhea, fatigue due to difficulty absorbing nutrients.

• Diabetes: as the pancreas produces insulin, diabetes is a frequent outcome after total pancreatectomy
• Other effects: fatigue, depression, and sleep disturbances

With proper postoperative care, dietary guidance, and medical follow-up, most of these side effects can be effectively managed.

Management of side effects

The side effects of total pancreatectomy can be managed with :

• Medication: to relieve pain, regulate diabetes, etc.
• A special diet: A special diet can help improve digestion and prevent certain deficiencies.
• Regular check-ups: Regular check-ups with your healthcare team are essential to monitor your health and adjust your treatment if necessary.

Everyone reacts differently to surgery. Don't hesitate to talk to your healthcare team if you experience any side effects, no matter how minor. Early treatment can often relieve them and improve your quality of life.