What's recovery after distal pancreatectomy and splenectomy like?

I had a distal pancreatectomy/splenectomy in 2016 (7 years ago). At that time I was in my late 20's. A few things have changed in my life after my pancreatectomy. First I no longer have daily pain now that my tumor is gone, that is the good news. However, I can no longer drink alcohol due to getting pancreatitis from consumption. I also now take digestive enzymes with all my meals to better digest food. I have also had two pregnancies since my pancreatectomy and got bad gestational diabetes with both babies and had to go on insulin. But going back to 2016 for post surgery recovery I was in the hospital for 11 days. My procedure was done at Mayo Clinic laparoscopically. I had some post surgery complications my incision site on my pancreas leaked and I had to get a drain put in. I got to wear this drain for a month. It does take a lot to care and clean the drain daily. Also once my drain was put in I had to get a nose tube put in to suck the leaking pancreatic fluids from my stomach, so I was hooked up to a bed for three days straight. This was the worst part of my recovery since I could not talk or eat with my nose tube in. After I got my nose tube taken out I was so weak from not eating or moving for days that I had to use a walker to walk. I sure did not feel like a 27 year old at this point. My full recovery time till I felt pretty good to eat normally and leave the house was about 12 weeks. Feel free to reach out to me if you need any support or have questions.

Guaranteed quick recovery from everything when you travel for fun. Especially if it includes walking and sunshine!

@gamaryanne Encouraged to read about your recovery and the fact that you have been able to travel to Portugal. Must have felt great. Congratulations. I had a laproscopic/robotic distal panreadectomy and splenectomy at MGH in Boston on May 17. Was discharged 48 hours after surgery and recuperation has been relatively easy. I was up and about every day and increased walking up to 3 miles by the end of week two. I just started the first of 8 cycles of chemo (oxaliplatin, irinotecan and 5Fu) So far no side effects. However I undersatnd that side effects may accumulate over the course of treatment. Although I know that every patient is different, any advise you have to offer would be appreciated. At the conclusion of chemo I'll be doing 28 days of radiation. Looking forward to a time when we can make up that trip to Amstredam planned for early May that was abruptly cancelled due to my diagnosis. Thanks in advance, Steve

I am sorry to hear that. Can I ask why you had to have it done?

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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