Pancreatic surgery offers some of the most challenging procedures in general surgery. The pancreas gland is located deep in the abdomen (the retro-peritoneum) and is surrounded by many vital and delicate anatomical structures. Surgery of the pancreas is mostly done for one of the following three indications:
Blunt abdominal trauma can lead to a fracture of the pancreas. In order to avoid a leak of pancreatic secretions, Dr Cooper will remove the body and tail of the pancreas and tie the ruptured pancreatic duct, through a procedure called distal pancreatectomy. The surgeon may perform this procedure in a manner that preserves the closely associated spleen.
In acute pancreatitis necrotic (dead) parts of the pancreas can become infected. In order to remove the infection, a 'debridement' (removal of all dead pancreatic tissue) is performed. Dr Cooper may remove the dead tissues of the pancreas from the front in an open surgical procedure or from the back in a minimally invasive manner. In chronic pancreatitis, Dr Cooper may use pancreas surgery to treat the symptom of chronic pain. Surgical procedures employed here, aim to resect the head of the pancreas and relieve pressure in the pancreatic duct or both.
- Tumours of the pancreas:
Tumours of the pancreas are fortunately quite rare. They can be cystic or solid, benign or malignant and situated in the head, body or tail of the pancreas. They can also be hormonally active, i.e. secrete insulin, glucagon, etc. Tumours in the tail of the pancreas are usually treated with a distal pancreatectomy with splenectomy, whereas tumours in the head of the pancreas are treated with a 'Whipple' procedure. The Whipple procedure involves Dr Cooper removing the head of the pancreas, gallbladder, bile duct, duodenum, 1st 10cm of the small bowel and potentially the distal 1/3 of the stomach. Continuity is then restored by joining the small bowel to the pancreas, remaining bile duct and stomach.