"pancreatectomy, proximal sub w/duodenectomy,w/pancreaticojejunostomy" was on the Blue Shield surgery approval letter under service provided area. I got it yesterday through. What exactly they will do on me?
1. A pancreatectomy is the surgical removal of the pancreas. A pancreatectomy may be total, in which case the entire organ is removed, usually along with the spleen, gallbladder, common bile duct, and portions of the small intestine and stomach. A pancreatectomy may also be distal, meaning that only the body and tail of the pancreas are removed, leaving the head of the organ attached. When the duodenum is removed along with all or part of the pancreas, the procedure is called a pancreaticoduodenectomy, which surgeons sometimes refer to as "Whipple's procedure." Pancreaticoduodenectomies are increasingly used to treat a variety of malignant and benign diseases of the pancreas. This procedure often involves removal of the regional lymph nodes as well.
http://www.surgeryencyclopedia.com/La-Pa/Pancreatectomy.html
Pancreaticoduodenectomy (also called a Whipple procedure) refers to the surgical removal of part of the common bile duct, the gallbladder, the duodenum, the pancreas down to its middle section, and sometimes part of the stomach. The lymph nodes that surround these organs are removed in the presence of a malignancy. The middle part of the small intestine (jejunum) is then attached to the remaining parts of the pancreas and bile duct so that pancreatic secretions (digestive enzymes) and bile still flow into the intestinal tract. Pancreatic cancer must be relatively confined. Even then, only 20% of cancers of the head of the pancreas are resectable (Way 645).
Diseases that put an individual at risk for needing pancreaticoduodenectomy are pancreatic cancer, tumor of the bile duct, inflammation of the pancreas (pancreatitis), chronic pancreatitis, pancreatic trauma, and pancreatic cysts. |
2. Pancreaticoduodenectomy (also called a Whipple procedure) refers to the surgical removal of part of the common bile duct, the gallbladder, the duodenum, the pancreas down to its middle section, and sometimes part of the stomach. The lymph nodes that surround these organs are removed in the presence of a malignancy. The middle part of the small intestine (jejunum) is then attached to the remaining parts of the pancreas and bile duct so that pancreatic secretions (digestive enzymes) and bile still flow into the intestinal tract. Pancreatic cancer must be relatively confined. Even then, only 20% of cancers of the head of the pancreas are resectable (Way 645).
Diseases that put an individual at risk for needing pancreaticoduodenectomy are pancreatic cancer, tumor of the bile duct, inflammation of the pancreas (pancreatitis), chronic pancreatitis, pancreatic trauma, and pancreatic cysts. http://www.mdguidelines.com/pancreaticoduodenectomy |
3. Pancreaticojejunostomy is a surgical procedure where the pancreatic duct, which permits drainage of digestive juices (pancreatic enzymes) from the pancreas, is opened and reconnected to the small intestine (jejunum).
Pancreaticojejunostomy is most often used as a treatment for individuals with an inflamed pancreas (chronic pancreatitis) and its accompanying pain. Chronic pancreatitis often causes the common bile duct and/or the pancreatic duct to become obstructed by mineral deposits (calculi), resulting in ongoing and severe pain. In the US, the most common risk factor for chronic pancreatitis is alcoholism. Other causes may include a hereditary predisposition and obstruction of the pancreatic duct resulting from duct narrowing or pancreatic cancer. On rare occasions, an episode of severe acute pancreatitis makes the pancreatic duct so narrow that chronic pancreatitis results. In many cases, the cause of chronic pancreatitis is not known. |
| Pancreaticojejunostomy is performed to improve drainage through the pancreatic duct and help relieve the pain of chronic pancreatitis. Other diseases that may be treated using pancreaticojejunostomy include pancreatic cancer, and obstruction of the pancreatic duct by cysts, traumatic injury, or foreign bodies (e.g., parasitic worms). |
Pancreaticojejunostomy is a major surgical procedure requiring a hospital stay. The procedure is performed under general anesthesia and involves making an incision across and through the upper abdominal wall (upper midline or transverse incision) to completely expose the pancreas and other abdominal organs (laparotomy). The pancreatic duct is exposed and opened lengthwise and the small intestine (jejunum) is cut into two sections. The pancreas with its opened duct is then inserted and stitched into the lower section of the jejunum. The upper section of the jejunum is reattached to its lower section (anastomosis) at a point below the pancreas and the abdomen is then closed. A urinary catheter may be inserted to facilitate bladder elimination.
Postoperative medications (opioid analgesics) and nonsteroidal anti-inflammatory drugs (NSAIDs) are administered at regular intervals to alleviate pain. Individual remains in the hospital an average 16 days until he or she is able to move (ambulate) on his or her own, diet returns to normal, and it is clear there are no other postoperative complications. Abdominal sutures are removed 2-3 weeks after surgery on an outpatient basis. |
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