science

Pancreatectomy

Pancreatectomy is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Pancreatectomy rather than just read about it. In short: In medicine, a pancreatectomy is the surgical removal of all or part of the pancreas. Several types of pancreatectomies exist, including pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy.

Key takeaways

Pancreatectomy belongs to science; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Pancreatectomy to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Pancreatectomy from memory before moving on to harder problems.

Reference excerpt

In medicine, a pancreatectomy is the surgical removal of all or part of the pancreas. Several types of pancreatectomies exist, including pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy.

History Pancreatic surgeries have been reported as early as the 1800s, however the first successful complete pancreatectomy was reported in 1944. Surgery on the pancreas is complex, at times requiring both the resection, or removal of parts or the entire organ, as well as anastomosis, or the connection of different parts of the digestive system. Advances in technology have allowed for the improvement in outcomes, reduction of complications, and improvement in surgical techniques.

Pancreatic anatomy and function

The pancreas is a digestive and endocrine organ that serves as a gland. It releases endocrine and exocrine hormones to help with metabolism and digestion. The pancreas is located behind the stomach. It is divided into the head, neck, body and tail. Some people have a fifth part of the pancreas known as the uncinate process. The pancreas contains a main pancreatic duct where the exocrine molecules collect and then drain into the duodenum via the common bile duct. There is also an accessory pancreatic duct that drains above the main duct straight into the duodenum. Blood supply to the pancreas comes from the celiac artery and the superior mesenteric artery, branches of the aorta.

Exocrine function The pancreas releases digestive enzymes into the gastrointestinal tract via the pancreatic ducts. These enzymes make it possible to break down food and materials in the small intestine allowing nutritional molecules to be absorbed. The enzymes include trypsin and chymotrypsin which help digest proteins, amylase which breaks down carbohydrates, as well as lipase which breaks down fats. The pancreas has majority exocrine function.

Endocrine function The pancreas is also made up of areas of cells known as pancreatic islets which include alpha, beta, and delta cells. Alpha cells secrete glucagon, beta cells secrete insulin, and delta cells secrete somatostatin, all of which are important hormones for metabolism. The endocrine function of the pancreatic glands is only 1-2% of pancreatic function.

Indications Pancreatectomies may be performed for a variety of reasons, including:

Inflammation Necrotizing pancreatitis Chronic pancreatitis Trauma Neoplasms (Tumors) Adenocarcinoma (85%) Cystadenoma (mucinous/serous) Cystadenocarcinoma Islet cell tumors (neuroendocrine tumors) Papillary cystic neoplasms Lymphoma Acinar cell tumors Severe hyperinsulinemic hypoglycemia

Types of Pancreatic Surgery

The most common surgical procedure involving removal of a portion of the pancreas is called a pancreaticoduodenectomy.

A distal pancreatectomy is removal of the body and/or tail of the pancreas. It is considered the standard procedure for cancer lesions found in the body or tail of the pancreas. The surgery is considered safe, with low morbidity and mortality, with the exception of in the case of pancreatic adenocarcinomas, a type of cancer that has a poor prognosis. Both open and laparoscopic techniques have been used for this type of surgery. Robot-assisted pancreatectomy also offers benefits in the morbidity and mortality. A segmental pancreatectomy is used to remove part of the pancreas so that there is not an excess of loss of pancreatic tissue. It is used in instances pf benign or low-grade tumors of the pancreatic neck and body. A study by Du et. al. published in 2013 showed decreased intraoperative hemorrhage and risk of post-operative diabetes, however, there was an increase in pancreatic fistula rate in patients that underwent a middle segmental pancreatectomy. A total pancreatectomy is the complete removal of the pancreas. It is a surgery used to remove the entire pancreas for issues such as chronic pancreatitis or advanced pancreatic cancers if non-surgical techniques do not work. This surgery is known to have disadvantages, however, over the years, surgical techniques as well as the surgical outcomes have improved. Total removal of the pancreas can lead to an insufficiency of hormones produced. In total pancreatectomy, the gallbladder, distal stomach, a portion of the small intestine, associated lymph nodes and in certain cases the spleen are removed in addition to the entire pancreas. TP-IAT (total pancreatectomy with islet autotransplantation) has also gained respectable traction within the medical community. These procedures are used in the management of several conditions involving the pancreas, such as benign pancreatic tumors, pancreatic cancer, and pancreatitis. TP-IAT is used to prevent post-operative diabetes and the subsequent complications. The islet cells are isolated from the explanted pancreas into the portal vein in order to help mitigate the loss of endocrine function following total pancreatectomy.

Contraindications

Reasons why patients should not receive a specific treatment to the disease/illness are known as contraindications. Contraindications to pancreatectomies include a patient's other medical history or comorbidities, poor functional status of the patient, and/or bleeding issues. Contraindications to pancreatectomy also can vary by type. In distal pancreatectomies, lesions that are not fully able to be removed are considered contraindications.

Complications Among the common complications of complete or nearly complete pancreatectomy are deficiencies of pancreatic endocrine or exocrine function, requiring replacement of insulin or digestive enzymes. Patients can develop type 1 diabetes after pancreatectomy and a study by Kim et al. determined that patients with BMIs >25 kg/m2 had higher incidences of pancreatic diabetes after distal pancreatectomy. Type 1 diabetes can be treated with careful blood glucose monitoring and insulin therapy. Complications also include fistulas, or the formation of an abnormal connection between two organs, and pancreatic leakage, where digestive enzymes can leak through the formation of the fistulas. Treatment for pancreatic leaks after surgery can include stenting and occlusion of the pancreatic duct, the use of octreotide, a drug that mimics somatostatin which inhibits secretion from the pancreas, or two other types of surgeries that remove part of the stomach or small intestine along with the pancreas.

… excerpt ends here. Continue reading the full article.

Illustrations

Worked examples

Example 1 — a first encounter with Pancreatectomy

Start with the simplest possible case. Write down what Pancreatectomy claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Pancreatectomy before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Pancreatectomy ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Pancreatectomy

In research: Pancreatectomy appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Pancreatectomy in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Pancreatectomy is common in secondary-school and first-year university syllabi. It links to neighbouring topics Accessory digestive gland surgery, Pancreatic cancer, Surgical oncology, so understanding it makes those chapters shorter.
In everyday life: Look for Pancreatectomy outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Pancreatectomy in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Pancreatectomy means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Pancreatectomy out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Pancreatectomy in simple terms?

Why does Pancreatectomy matter?

Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Pancreatectomy?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Pancreatectomy.