What's recovery after distal pancreatectomy and splenectomy like?

I am 3 weeks post distal pancreatectomy with spleen removal. I am a 68 YO male who was in fine condition prior to surgery. It has been miserable! Shooting pain when I breathe, nausea, fever and lack of appetite. 9 days in the hospital….then got to go home and sleep in my own bed. The most wonderful feeling. Spiked a fever…..doctor can’t figure out exactly why……getting antibiotics and hoping.

Thank you-that information is so helpful! Our surgeon cannot do it laparoscopically and has to do an open surgery apparently. He explained why it has to be open but it is kind of a blur since this was a shock to hear. I will ask again. I appreciate a response.

@breezygirl i Also had a distal pancreadectomy for tumor in tail of pancreas, which included spleen removal.
This surgery did require a few weeks of “relaxing” but by no means was I bedridden. Just sore when yawning or laughing for awhile. The surgery normally does not take very long with an experienced surgeon that does it laperoscopically. Lots of immunizations afterwards. Not only have I never had Covid, but I haven’t even contracted a cold since the surgery in December, 2022. Last month i travelled to Portugal for a little vacation. shoulder to shoulder often !
my health, even after 14 rounds of Fulfurinox, was good. so my case is different than your husband's. Just be sure the surgery is done by Lap with a surgeon very experienced with the DaVinci machine they use! a pancreas/liver/hepobiliary specialist.

I had a distal pancreatectomy and splenectomy in July 2022. I had an IPMN cyst on the main duct in the tail of the pancreas. As it was explained to me by the surgeon, the decision for spleen resection or not would be made at some point during surgery. As I understand it, in most cases, the blood vessels shared by the pancreas and spleen are so intertwined that the cleanest and safest route is to remove the spleen ( I believe that is the rationale). I needed to get pre-surgery and post- surgery shots for meningitis and pneumonia, with periodic boosters scheduled for two and five years out, and that is the only requirement after spleen removal. I hope this is helpful. Best wishes.

Thank you! Great ideas and thoughts. Surgeon said spleen will be removed which is a concern

@breezygirl , with 40% of his pancreas dead, I would ask the docs what good the remainder of his pancreas is currently doing -- specifically whether it's producing enough insulin and digestive enzymes to justify its existence.

If not, a) is total pancreas removal an option vs. distal? That could at least prevent the rest of a "decomposing" pancreas from getting inflamed again or turning malignant; and b) does his condition also require removal of his spleen, or can/should it be preserved?

I'm not a medical expert on any of this, just a patient whose remaining pancreas went rogue (cancerous again) after Whipple. I was at peace with my dependence on enzymes and insulin, but total pancreatectomy __might__ have spared me from needing chemotherapy on top of it.

FWIW, there are several research papers out there on total pancreatectomy vs Whipple, and on spleen-preserving distal pancreatectomy (SPDP) vs distal plus splenectomy (DPS). I haven't read enough to see if there is a consensus, but it sounds like the results are mixed enough that an individual surgeon could consider all the patient-specific tradeoffs and make a recommendation.

From the first paper I scanned: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210976/
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Conclusions

Spleen-preserving distal pancreatectomy using the Warshaw technique is associated with lower postoperative morbidity than DPS. Lower WBC and platelet counts suggest better splenic function in SPDP patients.
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I guess no other procedures are suggested. Removing 40% of the pancreas (the tail) and the spleen. Our surgeon said we could decide against this but he might continue to have pancreatitis and pain always. We just need to speak to someone who has had this done for this reason and get some advice.

Welcome @breezygirl, I moved your question about distal pancreatectomy with splenectomy to this existing discussion:
- What's recovery after distal pancreatectomy and splenectomy like? https://connect.mayoclinic.org/discussion/recovery-after-distal-pancreatectomy-and-splenectomy/

I did this so you can read previous posts and connect with members who have had this procedure like @blw77 @skkirby @leighs2011 @faithjlv @ken240 @cathyras @patti303 @nhow234 @avargas @gamaryanne @kim1965 and many others.

What options other than surgery are being considered for your husband, @breezygirl?

As a footnote, he does not have cancer, just that 40% of his pancreas is dead and diseased from the nectrozing pancreatitis, has anybody else experienced this, and did your doctor/surgeon recommend this surgery? Any comments are appreciated as we don't know whether to have this surgery or not. He also has parkinsons disease and type 2 diabetes so his overall health is not all that good.

We are new to this site, as I am searching because my husband will be having a distal pancreatectomy with splenectomy. We need to speak to someone who had it done. He has been suffering with ongoing chronic pancreatitis, in and out of hospitals for the past 1.5 years, numerous scans, mri's, EUS, MCRP's and ERCP. He has suffered with pain and they need to remove the tail and spleen. Would you recommend this surgery for relief from the pain? Does it improve the quality of life. Any honest feedback is requested before we decide to go forward with th8i removal.