What's recovery after distal pancreatectomy and splenectomy like?

Posted by blw77 @blw77, Jun 6, 2022

Can anyone give me information on how their recovery was after distal pancreatectomy and splenectomy? After 2 years of MRIs every 6 months and watching an MNC slowly but steadily grow, my doctor said that I should have this procedure. I'm 45 and typically a fairly healthy and active female. I'm trying to figure out how much time I'll need to be off of work or if I can manage to squeeze in in during the summer yet while I'm off.

Thank you for any information you have!

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Food in the freezer and some help lined up.

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@kellietg23

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?

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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.

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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.

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@breezygirl

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.

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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.

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@breezygirl

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.

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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?

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@colleenyoung

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?

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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.

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@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.

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

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@breezygirl

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

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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.

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@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.

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