Pancreatic Cancer Surgery

PANCREATIC CANCER SURGERY INFORMATION FORM
In patients diagnosed with pancreatic tumors, there is no necessity to take a biopsy to determine the nature of the tumor. Surgery should be performed if there is no evidence of vascular invasion into major blood vessels based on the results of Dynamic CT and/or Dynamic MR.

In patients with jaundice before surgery, a procedure called ERCP or PTC, which involves placing stents in the bile ducts, can be performed to expect a reduction in jaundice levels until the surgery date.

1- Pancreatic Head Tumors.
Pancreaticoduodenectomy performed for tumors in the pancreatic head is a complex and high-risk procedure. The average operation duration for the procedure is 5.5 hours, with an average blood loss of 350 ml, and a mortality rate around 4%.





 

Usually, a surgical procedure known as the Whipple procedure is performed. During the operation, the gallbladder, a portion of the bile ducts, the duodenum, the head of the pancreas, and the last part of the stomach are removed, and lymph node clearance is conducted around major blood vessels. After the removal process, three or four different connections (anastomoses) are created between the pancreas, bile ducts, and stomach.

While every anastomotic (joiningstitching) line is crucial, the one between the pancreas and the small intestine holds significant importance. Globally, approximately 12% of pancreatic fluid leakage can occur among these stitches. The size and degree of the leakage may vary,  affecting the patient's clinical  condition and treatment. Leakage can either self-seal, require specific drug therapy, or necessitate a            return to surgery. Grade A represents the lowest fistula level, whereas Grade C, the highest degree of leakage, is of vital importance.

Another crucial stitching area is between the bile ducts and the intestines, where bile leakage may occur. In the presence of such a situation and an externally attached tube called PTC is present, additional treatment is not necessary. If not applied before the surgery and such a complication arises, the necessity of attaching a PTC arises.

Ameliyat Like in other postoperative surgeries, complications such as bleeding, injuries to other organs, and intra-abdominal abscesses can occur after this surgery as well. The patient is monitored in the intensive care unit for precautionary measures post-surgery. The transition from intensive care is determined by the patient's overall condition, the presence of heart-lung issues, and the absence of any surgical problems. Patients without such issues are transferred to regular ward follow-ups, and the average hospital stay is around 7-10 days without complications. In case of complications, hospital stays and required treatments may vary.

After the surgery and during the discharge period, our dietitians create a nutrition plan for the patient. High-protein medical nutrition products are recommended.
After discharge, patients are called for an early check-up on the 10th day. The check-up includes assessing the patient's overall condition, the state of stitches, and blood parameters. Symptoms are evaluated, and additional tests are requested if necessary. A dietitian's assessment is conducted, and pathology results must be thoroughly examined. Based on pathology findings, necessary evaluations and guidance will be provided. The next check-up is scheduled for the 1st month, with subsequent follow-ups determined based on pathology and examination results.