pancreatectomy
Meaning of pancreatectomy: Removing part or all of a gland that quietly does two unrelated jobs, so what is taken decides which of them stops.
Definition of pancreatectomy
A pancreatectomy is an operation to remove all or part of the pancreas. Which version is performed depends on where the problem sits: the head, the body and tail, or the whole gland. Because the head shares its blood supply and its drainage with the duodenum and the bile duct, taking the head means taking those structures with it.
Which operations does the word cover?
| Operation | What is removed | Usual reason |
|---|---|---|
| Whipple procedure | Head of pancreas, duodenum, gallbladder, lower bile duct | Tumor of the head or the bile duct |
| Distal resection | Body and tail, often with the spleen | Tumor or cyst toward the tail |
| Central resection | A middle segment only | A small harmless lesion, sparing tissue |
| Total pancreatectomy | The whole gland, spleen, duodenum, bile duct | Disease scattered through the gland |
A distal pancreatectomy is the least disruptive of these because the tail sits away from the ducts and the duodenum, and the surgeon has only one cut surface to close.
Why does removing the head take so much with it?
Anatomy leaves no choice. The head of the pancreas sits in the C-shaped curve of the duodenum, wrapped around it, sharing the same small arteries. Separating the two would leave the duodenum without a blood supply. The common bile duct runs through the substance of the head on its way to the bowel, so it goes as well, and the surgeon must then rebuild three separate connections: pancreas to bowel, bile duct to bowel, and stomach to bowel. The join between the soft pancreas and the bowel is the weak point, and leakage of enzyme-rich fluid from it is the characteristic complication of the operation.
What is lost when the whole gland goes?
Two functions at once. The gland makes digestive enzymes, so without it fat and protein pass through undigested unless enzymes are replaced with every meal. It also holds the islets that make insulin and glucagon. Losing insulin produces diabetes, but losing glucagon at the same time removes the body's own defense against a blood sugar that falls too low, which makes the resulting diabetes markedly harder to steady than the ordinary kind. Where the spleen goes too, susceptibility to certain bacteria rises permanently.
Also known as
Used in a sentence
A distal pancreatectomy was performed with removal of the spleen.
Good to know
Removing the entire pancreas takes away glucagon as well as insulin, so the diabetes that follows is unusually unstable, and the loss of digestive enzymes prevents normal absorption of fat unless they are replaced.
Word origin
Where “pancreatectomy” comes from
Greek pankreas, from pan, all, and kreas, flesh, described an organ that looked uniformly fleshy; -ektome means cutting out.