What's recovery after distal pancreatectomy and splenectomy like?

Hello @kim1965,

I appreciate the update on your wife's post-surgery recovery. It is good to know that she is seeing improvement. You are so right to advise @milagro45pr to eat small meals and/or "grazing" as you said after surgery. It takes a while for the digestive tract to heal and normalize itself after extensive surgery.

Were there any types of foods (or liquids) that were especially helpful when your wife began to eat?

@milagro45pr
My wife @kim1965, had same surgery March 1, and some of the same complications with pain. Our day 2 was good though, but day 3 was bad with difficulties breathing. They found a blood clot in both lungs, from the surgery and started blood thinners. Hang in there, her situation improved to where they sent her home on day 5, only to be brought back to the hospital 2 days later for 2 more days. She is now almost 3 weeks out from surgery and is doing better eating, trying to walk every day(maybe 20 minutes), but let your body rest when you get home. The eating will be slow to progress, more like grazing, as very difficult to eat a full meal, but it gets better. We hope she will improve quicker now with the walking per surgeon suggestions. I wish you all the same, and if there is any questions we can help with please let us know, and we will try to share what we can that worked for us.

I had a open distal pancreatectomy with splenectomy on March 10. First day after surgery was pretty brutal . They were pumping me with tramadol gabapentin, fentanyl, Thea and epidural, but the pain was still there, and I was so sick to my stomach that I couldn’t barely get up without feeling that I was gonna fall flat on my face. They two anesthesiologist came by and I told them to replace my Fentanyl with some thing else because it was making me to sick to be able to get up. They remove the fentanyl and replace it with numbing medication. My my surgeon asked me if I wanted to try Toradol for the pain because I was so sensitive to all narcotics. At the moment I asked her to remove the gabapentin and tramadol since it wasn’t working. Just with the numbing medication and the toradol was enough to control my pain. Foley was removed on the second day, and I was advanced to ice chips, which I wasn’t very happy because I was so thirsty I would have thought I would have I have been through the desert for 10 days without having a sip of water Day three of us moving better less pain. On day three I started having some chills and I told the nurse to take my temperature when she did invite a low-grade fever of 99.9 they immediately got an order for an x-ray of my chest and it showed that I had a pneumonia that had developed overnight, they immediately got orders to put me on three different antibiotics while they try to figure out what ham type of pneumonia or if I had other infection in the body that they did not know about.my white blood cell count was really high and my red blood cell count was really low . This routine continue for the next four days. I had blood from every day and x-ray done every day to check. The pneumonia was improving and my blood counts were improving. On the six my surgeon decided to get a consult from a pulmonologist to see if it was OK to get aspiration of the fluid in my lungs to see if it was infected. When it was finally scheduled, and then ultrasound was done to see how much liquid they noticed that it was beginning to be reabsorbed in my body and it was not worth it take any risk of inserting a needle into my lung space and puncturing a lung , and they said that it was better to just watch it and let it resolve on Its own. And on the morning before I was his charge, an x-ray was performed with my chest and it showed that the fluid in my lung was almost reabsorbed into my body. Results of the masses removed were like clean clean margins around him low grade one tumor contained within its base. No further treatment will be needed.

Hi there-
Yes, you are correct: if the spleen can be saved, long term your wife will be able to fight off infections easier, however, most surgeon's will remove it because it has such a rich blood source and is connected to the pancreas. My suggestion would be to share that concern with your surgeon. When I asked my surgeon about this same concern, he explained that he would try to save it, however, it's a very tricky and complicated surgery. My surgery started as laparoscopic but was converted to an open surgery. I would ask about drainage tubes, of the cancer has metastasized, what grade/type of tumor(s) they found, length of hospital stay, probable outcomes, and what vaccinations she will need for life if the spleen is removed. Due to my spleen being removed, I need numerous vaccines at varying intervals for the rest of my life. I would inquire about that also. I would be very interested to hear the outcome of your wife's surgery. I currently have a lesion on my liver that is small, however, my oncologist is watching it closely. I wish you and your wife peace as you head into the unknown. It can be scary but know that you have a huge support network here at Mayo Connect. If I can help further, please let me know.

Warmest Regards,
Sherry

Hi there-

Did you get relief from the pancreatic enzymes?

Thanks,
Sherry

At my treatment facility there is a dietician who works with the hepatobiliary/pancreatic cancer patients. It was quite helpful. You could see if your surgeon can refer you to a gastroenterologist with extensive knowledge of pancreatic disease. The gastroenterologist who did my biopsy and stent did a great job but when I asked about pancreatic insufficiency, he wasn't sure. The oncologist immediately gave me pancreatic enzymes which was a huge help. When I went to see a surgeon for second opinion, he asked me about my symptoms. I told him I was having a lot of difficulty with gas, loose stools on the dose I was taking, he advised to increase. Just the ticket! I have involvement of the superior mesenteric vein so I am not a candidate for surgery at this time and will go back in another month to get another CT scan. I am most thankful for the good advice of the surgeon and hepatobiliary dietician, greatly improved the quality of my life. If the surgeon isn't able to help with your symptoms, perhaps a referral to someone in another discipline could help. Quality of life is very important to me, but might not always be a top priority of a surgeon. Keep looking for help with managing your symptoms.