What's recovery after distal pancreatectomy and splenectomy like?

@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.

I remember feeling terrified! My surgery was March 3. Similar to you, discovery of a MCN happened incidental to an ultrasound for another purpose. No symptoms. Open surgery because of the large mass (9 cm). Very thankful this was discovered.

Surgery on Friday, walking on Sunday, soft diet on Tuesday and discharged on Wednesday. As many have said, walking is good. Was discharged with a drain which seemed to give me more discomfort than the incision. After discharge, pain was managed with Tylenol. Today was the first day with no Tylenol.

Surgeon suggested that digestion may not be an issue since the pancreas was probably not working properly for a while because of the large mass. So far, he seems to be right. Small meals to start. Portion sizes are still smaller than pre-surgery....which is probably good anyway 🙂

Suggestions for what you might need:
(1) Ensure or some other supplement to get the calories and protein you need in the event you don't have much of an appetite.
(2) Shower chair. My daily shower helped me feel so much better.
(3) Gauze (4x4) if you are discharged with a drain.
(4) Rest.

Wishing you an uneventful surgery and a speedy recovery.

Food in the freezer and some help lined up.

I had an EUS biopsy. Dr had difficulty getting a good tissue sample. Results were inconclusive. Said they could perform a 2nd biopsy but odds of getting an accurate sample were not good due to location of tumor. A biopsy will be done post surgery. The tail of my pancreas is atrophied.
I’m spending this week cleaning the house and setting up my bedroom with what I think I’ll need;) Any suggestions for what I may like to have on hand?

Assume they biopsied it? Mine was adenocarcinoma. Operation was 5 1/2 hours but next day I was up and walking around. Stayed in hospital 3 more days. Went home without a lot of pain and all tubes out. Pretty routine from there. Tired, slept more than normal but no complications! You are going to do well!

Thank you for the uplifting words. The surgeon did say I am lucky; I’m in the 15-20% that can have surgery. Just feels weird that I will be having surgery when I have no symptoms & no family history. This surgeon was my 2nd opinion; just 2 weeks ago so vaccines will be post surgery. Sorry to hear of those that passed.