My Distal Pancreatectomy Experience: What to Expect скачать в хорошем качестве

My Distal Pancreatectomy Experience: What to Expect

Distal Pancreatectomy: A Comprehensive Overview #### Introduction Distal pancreatectomy is a surgical procedure involving the removal of the body and tail of the pancreas. This surgery is typically indicated for various conditions affecting these parts of the pancreas, such as pancreatic cancer, cysts, chronic pancreatitis, and neuroendocrine tumors. The procedure can be performed through traditional open surgery or using minimally invasive techniques like laparoscopy or robotic surgery. #### Anatomy and Physiology of the Pancreas The pancreas is a vital organ located in the upper abdomen, playing a crucial role in both endocrine and exocrine functions. It has four parts: the head, neck, body, and tail. The head of the pancreas lies near the duodenum, while the tail extends towards the spleen. The organ is responsible for producing insulin and glucagon (endocrine functions) as well as digestive enzymes (exocrine functions). The distal part of the pancreas includes the body and tail. A distal pancreatectomy involves the removal of these sections. This procedure sometimes necessitates a splenectomy (removal of the spleen) due to the close anatomical relationship between the tail of the pancreas and the spleen. #### Indications for Distal Pancreatectomy 1. **Pancreatic Cancer**: Tumors located in the body and tail of the pancreas often require distal pancreatectomy for curative or palliative purposes. 2. **Cystic Lesions**: Pancreatic cysts, including mucinous cystadenomas and intraductal papillary mucinous neoplasms (IPMNs), may necessitate surgical removal if they have malignant potential or cause symptoms. 3. **Neuroendocrine Tumors**: These rare tumors arise from the hormone-producing cells of the pancreas and can be benign or malignant. 4. **Chronic Pancreatitis**: In cases where chronic inflammation causes severe pain or complications, distal pancreatectomy may be considered. 5. **Trauma**: Severe injury to the body or tail of the pancreas might require partial removal of the organ. #### Preoperative Evaluation Before undergoing a distal pancreatectomy, patients must undergo a thorough preoperative evaluation to assess their suitability for surgery. This includes: 1. **Imaging Studies**: CT scans, MRI, and endoscopic ultrasound (EUS) are critical for evaluating the location and extent of pancreatic lesions. 2. **Laboratory Tests**: Blood tests to assess pancreatic function, including serum amylase and lipase levels, and to evaluate overall health. 3. **Biopsy**: In some cases, a biopsy may be performed to determine the nature of the pancreatic lesion. 4. **Cardiopulmonary Assessment**: Evaluating heart and lung function to ensure the patient can tolerate the procedure. 5. **Nutritional Assessment**: Ensuring the patient has adequate nutritional reserves, as pancreatic surgery can impact digestion and nutrient absorption. #### Surgical Techniques Distal pancreatectomy can be performed using different surgical approaches, each with its own advantages and disadvantages. 1. **Open Distal Pancreatectomy**: This traditional method involves a large abdominal incision, providing direct access to the pancreas. It is often preferred for larger tumors or when the involvement of surrounding structures is suspected. 2. **Laparoscopic Distal Pancreatectomy**: A minimally invasive technique that uses several small incisions through which a camera and surgical instruments are inserted. This approach offers the benefits of reduced postoperative pain, shorter hospital stay, and quicker recovery. 3. **Robotic-Assisted Distal Pancreatectomy**: This technique also uses small incisions but employs robotic systems to enhance precision and dexterity. It combines the advantages of laparoscopy with improved surgical control. #### Surgical Procedure The steps of a distal pancreatectomy can vary slightly based on the chosen surgical technique but generally follow these principles: 1. **Anesthesia and Positioning**: The patient is placed under general anesthesia and positioned supine on the operating table. For laparoscopic and robotic procedures, the patient may be tilted to improve access to the pancreas. 2. **Incision and Exposure**: **Open Surgery**: A midline or transverse incision is made to access the pancreas. **Laparoscopic/Robotic Surgery**: Small incisions are made, and ports are inserted for the camera and instruments. Carbon dioxide gas is used to insufflate the abdomen, creating a working space. 3. **Mobilization of the Pancreas**: The surgeon carefully dissects around the pancreas to free it from surrounding tissues. Major blood vessels, such as the splenic artery and vein, must be identified and preserved or ligated as necessary.   • My Distal Pancreatectomy Experience: What ...   #alcohol and pancreas #anatomy #live surgery #pancreas cancer #pancreas surgery #pancreatic ductal adenocarcinoma #laparoscopic surgeon #surgeon #hernia surgery #viral #shorts #youtube #doctor #subscribe