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Diet After Distal Pancreatectomy And Splenectomy

The Morning Of Your Surgery

Distal Pancreatectomy Procedure | Roswell Park Patient Education

Instructions for Drinking Before Your Surgery

  • If your healthcare provider gave you a CF® drink, finish it 2 hours before your scheduled arrival time. Do not drink anything else after midnight the night before your surgery, including water.
  • If your healthcare provider did not give you a CF drink, you can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.

Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.

Take Your Medications As Instructed

A member of your care team will tell you which medications to take the morning of your surgery. Take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.

Shower With a 4% CHG Solution Antiseptic Skin Cleanser

Shower with a 4% CHG solution antiseptic skin cleanser before you leave for the hospital. Use it the same way you did the night before.

Do not put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.

Things to remember

What to bring

Where To Park

MSKs parking garage is on East 66th Street between York and 1st venues. If you have questions about prices, call .

There are other parking garages located on:

  • East 69th Street between 1st and 2nd avenues.
  • East 67th Street between York and 1st avenues.
  • East 65th Street between 1st and 2nd avenues.

Once youre in the hospital

Meet with a nurse

About Your Pancreas And Spleen

Figure 1. Your pancreas before your distal pancreatectomy

Your pancreas makes enzymes that help digest the food you eat, including fats. It also makes insulin and glucagon, which are hormones that help regulate your blood sugar levels. Your pancreas has 3 parts: the tail, the body, and the head.

Even though part of your pancreas will be removed during your surgery, theres usually enough of it left after your surgery to make hormones and enzymes.

  • If your pancreas doesnt make enough digestive enzymes after your surgery, you may have diarrhea. If this happens, you may need to take enzyme pills when you eat.
  • If your pancreas doesnt make enough insulin after your surgery, you may have high blood sugar. This is rare. If you have high blood sugar after your surgery, your healthcare team will help you.

Your spleen is located next to your pancreas. It makes white blood cells that help your body fight infections. Your spleen also filters your blood, stores blood cells, and destroys old blood cells. Your spleen may need to be removed if the tumor involves blood vessels that supply your spleen.

Study Design And Participants

This was a cohort analysis using data from a dedicated pancreatectomy database prospectively maintained by the Pancreatic Surgical Center, Peking Union Medical College Hospital. Clinical data, pathological details and long-term follow-up outcomes were extracted. All enrolled patients signed the written informed consent. From 1 January 2004 to 13 February 2016, patients were considered eligible for this study if they underwent DP with or without splenectomy for a pancreatic lesion. Patients with preoperative DM and those pathologically diagnosed with pancreatic duct adenocarcinoma, acinar carcinoma, or pancreatic secondary malignant tumor were excluded. The criteria of preoperative or postoperative DM were referenced by the American Diabetes Association 2017 diagnostic criteria.

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Nutritional Support In Patients Undergoing Pancreatectomy For Cancer

Nutritional intervention, either parenteral or enteral, in pancreatic cancer patients aims mainly to prevent or attenuate cachexia. During the last two decades, a number of clinical studies tried to answer the question whether perioperative nutritional support could be beneficial in patients with pancreatic carcinoma who are candidates for total pancreatectomy using parenteral or enteral nutrition. The results of these studies are subsequently analysed.

Can You Live Without A Pancreas

Traumatic Transection of the Pancreas. A Case of Delayed Presentation ...

Can you live without a pancreas?

Yes, you can live without a pancreas. Youll need to make a few adjustments to your life, though. Your pancreas makes substances that control your blood sugar and help your body digest foods. After surgery, youll have to take medicines to handle these functions.

Surgery to remove the whole pancreas is rarely done anymore. However, you might need this surgery if you have pancreatic cancer, severe pancreatitis, or damage to your pancreas from an injury.

Thanks to new medicines, life expectancy after pancreas removal surgery is rising. Your outlook will depend on the condition you have.

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Palliative Treatment After Major Pancreatic Surgery

Total pancreatectomy results in postoperatively altered endocrine function of the pancreas including insulin and glucagon secretion. It is well established that the concomitant administration of insulin and glucagon and the maintenance of blood insulin/glucagon ratio at a level similar to the physiological value are extremely important in order to improve the energy and nutritional metabolism following total pancreatectomy .

As it was mentioned earlier, proinflammatory cytokines play a significant role in cancer cachexia, and consequently drugs that could inhibit these cytokines would have beneficial effect in these patients. Thalidomide, an anti- TNF- drug could be beneficial in patients with cancer cachexia. The available data indicate that thalidomide can attenuate loss of weight and lean body mass in patients with advanced pancreatic cancer . Finally, administration of albumin does not improve the clinical outcome if it is given early in the postoperative period after gastrointestinal surgery .

A summary on the results of the main clinical studies related to perioperative nutritional supplementation in patients undergoing pancreatoduodenectomy is given in Table 1.

Day Before Your Surgery

Note the Time of Your Surgery

A staff member from the Admitting Office will call you after 2 p.m. the day before your surgery. If your surgery is scheduled for a Monday, theyll call you the Friday before. If you do not get a call by 7 p.m., call .

The staff member will tell you what time to arrive at the hospital for your surgery. Theyll also remind you where to go.

This will be the following location:

Presurgical Center on the 6th floor1275 York Avenue New York, NY 10065B elevator to 6th floor

Shower with a 4% chlorhexidine gluconate solution antiseptic skin cleanser

4% CHG solution is a skin cleanser that kills germs for 24 hours after you use it. Showering with it before your surgery will help lower your risk of infection after surgery. Your nurse will give you a bottle to use before your surgery.

The night before your surgery, shower using a 4% CHG solution antiseptic skin cleanser.

  • Wash your hair with your usual shampoo and conditioner. Rinse your head well.
  • Wash your face and genital area with your usual soap. Rinse your body well with warm water.
  • Open the 4% CHG solution bottle. Pour some into your hand or a clean washcloth.
  • Move away from the shower stream. Rub the 4% CHG solution gently over your body from your neck to your feet. Do not put it on your face or genital area.
  • Move back into the shower stream to rinse off the 4% CHG solution. Use warm water.
  • Dry yourself off with a clean towel.
  • Sleep

    Go to bed early and get a full nights sleep.

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    How Long Does Full Recovery Take For Pancreas Surgery

    by Dr. Albert Amini | Jul 13, 2021 | Pancreatic Diseases

    While modern medicine and technology make successful pancreas surgery more possible now than ever before, it is important for patients to understand that pancreatectomy, Whipple surgery, and other pancreas procedures are still complex, involved, and require a fairly extensive recovery period. The highly acclaimed team of experts at Arizona Premier Surgery is experienced in even the most difficult cases and is committed to giving patients the highest level of treatment and care possible before, during, and after pancreas surgery in Gilbert, Chandler, or Scottsdale, AZ. Learn more about what to expect after your pancreas surgery, including how long recovery may take.

    What Is Recovery Like After A Laparoscopic Distal Pancreatectomy

    Distal Pancreatectomy Surgery: 3) How to Prepare for a Successful Recovery

    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:

    Before you leave the hospital, you will receive detailed discharge instructions that cover the following:

    • Resuming activities

    • Follow-up appointments

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    How Long Is Recovery After Pancreas Surgery

    The details and length of pancreas surgery recovery will depend heavily on the patients condition, the type of pancreas surgery performed, the patients overall health, and other factors. In general, patients can typically expect to spend several nights in the hospital or ICU after pancreas surgery for close monitoring.

    Once patients have been released home to begin the remainder of their recovery, it is advised to have a trusted friend or loved one lined up to help around the clock for the first several days or weeks. Patients should devote the first portion of their recovery primarily to rest, though it is important to engage in light walks around the house to promote healthy circulation and to begin rebuilding their strength. Heavy lifting, straining, and exercise should also be paused for up to 6 8 weeks, or until your surgeon has deemed these activities safe and appropriate.

    For most patients, full recovery after pancreas surgery takes about 1 3 months. During this time, patients will need to attend all of their follow-up appointments and take care to adjust their eating habits and other routines to allow their healing digestive tract time to acclimate. Additionally, patients will likely need to have regular follow-up monitoring and take certain medications, including insulin, for the remainder of their lifetime.

    What Happens During The Pancreatectomy Procedure

    When its time for surgery, your healthcare team will help you onto the operating bed and your anesthesiologist will deliver anesthesia through an IV line in your arm. This will put you to sleep for the procedure. Your IV will continue to deliver fluids and medicine, and sometimes nutrition.

    Your healthcare team will place various tubes to support your body while youre under anesthesia. Youll have a tube in your windpipe to help you breathe and one in your stomach to prevent nausea. Youll have a Foley catheter to drain your pee and tubes in your abdominal cavity to drain excess fluids.

    Most pancreatectomies are performed through open surgery, which offers ready access to many organs at once. Some medical centers may be able to perform certain pancreatectomies through minimally invasive methods, such as laparoscopic or robotic surgery. These methods make recovery a little easier.

    If youre having open surgery, your surgeon will make one long incision across your abdomen to open your abdominal cavity. If youre having laparoscopic or robotic surgery, your surgeon will make several small keyhole incisions. Theyll operate through these, using long tools and a camera .

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    Questions About Diet And Surgery

    If you have any questions about managing your diet before or after surgery, speak to your doctor, nurse or dietitian. If you are having chemotherapy after your surgery, it is important to speak to them about any eating problems to make sure these dont delay the chemotherapy.

    If you havent seen a dietitian, ask your doctor or nurse to refer you to one it is important that you get specialist advice about your diet.

    You can also speak to our specialist nurses on our free Support Line.

    The Spleen: Remove Or Not

    Traumatic Transection of the Pancreas. A Case of Delayed Presentation ...

    The tail of the pancreas is nestled within the spleen, and the blood vessels that feed the spleen run right behind the pancreas. Often, the fist-sized immune organ is also removed during a distal pancreatectomy.

    How do doctors decide whether to save the spleen or remove it? It depends on the type of tumor you have.

    If its a more benign or precancerous tumor, surgeons may do a spleen-preserving procedure, where they just remove the tail of the pancreas. If the tumor is cancerous or suspected to be cancerous, they are likely to remove the spleen along with the pancreas.

    There are a couple of reasons for this. First of all, there are a lot of lymph nodes surrounding the tail of the pancreas and spleen, and removing the spleen as well as the tail of the pancreas reduces the risk of the cancer spreading to the lymph nodes it also increases the chances of capturing any spread that has already started.

    Secondly, there may be a need to remove the artery and vein that feed the spleen in order to get to the tumor.

    Although the spleen is extremely important in children and adolescents because of its immune function in filtering blood and controlling infection-fighting white blood cells, it has less importance as we get older.

    At some hospitals, if the spleen is removed patients are given a trivalent vaccine to protect against the biggest infections they might face: pneumococcal pneumonia, H. influenzae , and meningitis.

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    Postoperative Parameters Of The 2 Groups

    The time of nasogastric tube removed days, drainage-tube-off days and postoperative length of stay were remarkably reduced in the ERAS group . Although this study required two weeks fasting of patients, exhaust defecation time shows no difference between the two groups. Difference was observed in start with oral soft solid food between two groups because the ERAS group started intake until postoperative day 14 days. What we should emphasize is this: In ERAS group, there was no patient discharged with abdominal drainage tube. Nevertheless, there were still 7 patients treated with conventional procedure discharged with drainage tube.

    What To Expect During A Distal Pancreatectomy

    Patients are put to sleep for the procedure, which generally lasts around four hours. During the procedure, the abdomen is filled with gas to give the surgeon greater visibility of the pancreas and abdominal cavity. Two sets of tubes are inserted through the patients nose, into the stomach, to help prevent nausea/vomiting and to help fluids drain out during the surgery and during recovery.

    There are usually three incisions in the abdominal wall: one for a camera, one for surgical equipment, and one for the surgeons hand. The remaining part of the pancreas will be closed with sutures or staples.

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    Complications From A Laparoscopic Distal Pancreatectomy Are Minimal But May Include:

    • A fistula : This may occur if the sutures 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.

    Pancreaticoduodenectomy With Extended Lymphadenectomy

    Distal Pancreatectomy with and without splenectomy Techniques

    This type of operation involves removal of head of the pancreas, duodenum and distal common bile duct. However it accompanied in some percentage by at least two important complications namely gastric stasis and pancreatic fistula. Pancreatoduodenectomy results in loss of gastric pacemaker due to removal of the interstitial cells of Cajal. This, together with the physiologic consequences of pancreatic resection and biliary and pancreatic diversion, could result in post-operative gastric stasis .

    On the other hand enteral nutrition delays gastric emptying in patients who underwent Whipples resection for cancer of the pancreas. In a relevant study, among 62 operated-on patients, 30 received enteral and 32 non-enteral nutrition. Significantly greater proportion of delayed gastric emptying was observed in the first compared with the second group although they had longer hospital stay and longer duration of nasogastric tube compared with the non-enteral nutrition group .

    The development of lipid accumulation in the liver represents an uncommon but worrisome finding in totally pancreatectomized patients, a phenomenon that has also been described in experimentally pancreatectomized animals . It has been suggested that uncontrolled diabetes, weight loss, and malabsorption could be the main contributing factors. However, the severity of hepatic steatosis, even in patients with satisfactory blood glucose levels, suggests the co-existence of additional pathogenic mechanisms.

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    What Does The Pancreas Do

    The pancreas is a gland located in your abdomen, underneath your stomach. Its shaped like a large tadpole, with a round head and a thinner, tapered body. The head is curved into the duodenum, the first part of your small intestine. The body of the pancreas sits between your stomach and spine.

    The pancreas has two kinds of cells. Each type of cell produces a different substance.

    • Endocrine cellsproduce the hormones insulin, glucagon, somatostatin, and pancreatic polypeptide. Insulin helps lower blood sugar, and glucagon raises blood sugar.
    • Exocrine cellsproduce enzymes that help digest food in the intestine. Trypsin and chymotrypsin break down proteins. Amylase digests carbohydrates, and lipase breaks down fats.

    Operative Complications Related To Nutritional Status

    Nutritional status also seems to influence the rate of postoperative complications. In a relevant study it was found that preoperative low prognostic nutrition index and low preoperative serum levels of albumin were associated with poor survival and higher rate of postoperative complications, respectively. Low prognostic nutrition index and low BMI were associated with the appearance of pancreatic fistula .

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    Postsurgical Epi Can Be Treated

    If you develop EPI, it can be treated with pancreatic enzyme replacement therapy capsules that contain replacement digestive enzymes, according to the National Pancreas Foundation. PERT effectively treats EPI, Gardner says. Dosing is individualized, he adds, and determined by the content of your meals.

    People who develop EPI may also need to make some lifestyle changes, such as eating a healthy, nutrient-rich diet and taking vitamins and other supplements, according to the National Pancreas Foundation.

    Bottom line: EPI can develop or worsen after pancreatic surgery, but you can work closely with your doctor to find the best treatment and lifestyle strategies for you.

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