Pancreatic Surgery in Delhi, India

Pancreatectomy is a surgical procedure to remove part or all of the pancreas. It is performed to treat serious pancreatic conditions such as cancer, chronic pancreatitis, and tumours that affect the organ’s function. Depending on the condition, different types of pancreatectomy may be recommended, ranging from removing the head, tail or body of the pancreas to taking out the entire pancreas.

Since the pancreas plays a key role in digestion and blood sugar regulation, its removal requires careful management. Patients may need dietary adjustments, enzyme supplements, or insulin therapy after surgery to help the body function properly. The procedure is typically planned based on the severity of the condition, overall health, and the potential benefits of surgery.

Pancreatectomy procedures vary depending on how much of the pancreas needs to be removed and the specific condition being treated. At Max Hospital, different types of pancreatectomy are performed based on medical needs, ensuring patients receive the most appropriate surgical care.

Partial (central) Pancreatectomy

This procedure involves removing only the affected portion of the pancreas, usually neck, while preserving the remaining healthy tissue. It is often performed for localised tumours, cysts, or benign growths that do not require complete removal of the organ. Preserving part of the pancreas helps maintain digestive and insulin-producing functions as much as possible.

Total Pancreatectomy

In this surgery, the entire pancreas is removed. nearby structures such as the gallbladder, spleen, parts of the stomach, and small intestine are also removed if necessary. It is usually performed for widespread pancreatic disease, extensive cancer, or severe chronic pancreatitis that does not respond to other treatments. Since the pancreas plays a key role in digestion and blood sugar control, patients who undergo a total pancreatectomy require lifelong insulin therapy and enzyme supplements.

Distal Pancreatectomy

This procedure removes the tail and sometimes part of the body of the pancreas. It is commonly performed for cancer, tumours or cysts in the pancreatic tail. In many cases, the spleen is also removed during the surgery, as it shares blood supply with the pancreas.

Whipple Procedure (Pancreaticoduodenectomy)

This complex surgery is performed when a tumour or disease affects the head of the pancreas. It involves removing the head of the pancreas, part of the small intestine (duodenum), the gallbladder, and a portion of the bile duct. The remaining pancreas is then connected to the digestive tract to maintain essential functions. The Whipple procedure is mainly used to treat pancreatic and periampullary cancer but may also be performed for other tumours and disorders in the region.

A pancreatectomy is performed when a pancreatic condition causes severe symptoms, complications, or a risk to overall health. The procedure may be necessary for the following conditions:

• Pancreatic Cancer – Tumours in the pancreas, especially in the head of the organ, may require partial or total removal to prevent the spread of cancer. The Whipple procedure is commonly performed for this condition.
• Chronic Pancreatitis – Long-term inflammation of the pancreas can lead to severe pain, digestive problems, and irreversible damage. When other treatments fail to provide relief, surgery may be considered to remove the damaged portion of the pancreas.
• Pancreatic Cysts and Tumours – Some non-cancerous cysts and tumours can grow large enough to cause pain, blockages, or other complications. In such cases, removing the affected part of the pancreas may be necessary.
• Neuroendocrine Tumours – These rare tumours develop in the hormone-producing cells of the pancreas. Some may be cancerous, while others can cause serious hormonal imbalances. Surgery is often required to remove the tumour and restore normal function.
• Pancreatic Trauma – Severe injury to the pancreas from accidents or abdominal trauma may result in damage that requires surgical removal of part of the organ to prevent further complications.
• Hereditary Pancreatic Conditions – Certain genetic disorders, such as hereditary pancreatitis or a high risk of pancreatic cancer, may require a preventive pancreatectomy to reduce the likelihood of developing severe disease.

The type of surgery performed depends on the specific condition, the extent of pancreatic involvement, and the overall health of the patient.

Preparing for a pancreatectomy involves several things to ensure the body is ready for surgery and recovery. The process includes medical evaluations, lifestyle adjustments, and preoperative guidance. 

Medical Assessments

A series of tests, including blood tests, imaging scans (CT scan, MRI, or ultrasound), and sometimes endoscopic procedures, are conducted to assess the condition of the pancreas and surrounding organs. These tests help determine the most suitable surgical approach.

Consultations with Specialists

Meetings with the surgical team, anaesthetists, and other specialists help patients understand the procedure, potential risks, and post-surgical care requirements. Nutritionists may also provide dietary advice to prepare the body for changes after surgery.

Medication Adjustments

Certain medications, such as blood thinners, may need to be stopped or adjusted before surgery to reduce the risk of complications. The medical team provides specific instructions on which medications should be continued or discontinued.

Dietary and Lifestyle Preparations

In some cases, a special diet or nutritional supplements may be recommended to improve strength before surgery. Smoking and alcohol consumption should be avoided, as they can affect healing and increase the risk of complications.

Hospital Admission and Pre-Surgery Instructions

Patients are usually admitted on the day of surgery or a day before. Fasting for a specific period is required before the procedure. The medical team provides detailed instructions on what to expect on the day of surgery and during the initial recovery period.

Proper preparation helps ensure a smoother surgery and recovery, reducing potential risks and improving post-operative outcomes.

A pancreatectomy is a major surgical procedure that requires careful planning and execution. The duration and complexity of the surgery depend on the type of pancreatectomy being performed and the patient’s overall health.

• Anaesthesia Administration – The procedure is performed under general anaesthesia, ensuring the patient remains unconscious and free of pain throughout the surgery.
• Surgical Approach – Depending on the condition being treated, the surgeon may use an open or minimally invasive (laparoscopic or robotic-assisted) technique. Open surgery involves a larger incision, while minimally invasive methods use small incisions and specialised instruments for a shorter recovery time.
• Removal of the Pancreas or Affected Portion – The surgeon carefully removes the necessary part of the pancreas while preserving surrounding organs whenever possible. In some cases, parts of the stomach, small intestine, bile duct, spleen, or gallbladder may also need to be removed.
• Reconstruction and Reconnection – If parts of the digestive system are removed, the remaining structures are reconnected to allow normal digestion. For procedures like the Whipple surgery, the surgeon attaches the stomach, bile duct, and small intestine to ensure food can pass through the digestive tract.
• Monitoring and Completion – Once the surgery is completed, drains may be placed to remove excess fluids and prevent complications. The incision is then closed, and the patient is moved to the recovery area for close monitoring.

The duration of a pancreatectomy can range from several hours to longer, depending on the complexity of the procedure. After surgery, the patient is monitored in a recovery unit before being transferred to a hospital ward for further post-operative care

Recovery after a pancreatectomy varies depending on the type of surgery performed and overall health. Hospital stay, post-operative care, and long-term adjustments play a crucial role in the healing process.

• Hospital Stay and Initial Recovery – Patients typically remain in the hospital for one to two weeks. During this period, vital signs are closely monitored, and pain management is provided. A liquid or soft diet may be introduced gradually as digestion adjusts.
• Managing Digestive Changes – Since the pancreas produces digestive enzymes, dietary changes and enzyme supplements may be required to aid digestion. A nutritionist provides guidance on meal planning to prevent nutritional deficiencies.
• Blood Sugar Monitoring – If a total pancreatectomy is performed, insulin therapy is necessary as the body can no longer produce insulin. Blood sugar levels are monitored, and a diabetes management plan is provided if required.
• Wound Care and Activity Restrictions – The surgical site must be kept clean, and physical activity should be limited during the early recovery phase. Lifting heavy objects and strenuous activities should be avoided until cleared by the doctor.
• Follow-Up Appointments – Regular check-ups are scheduled to monitor recovery, assess nutritional status, and manage any complications. Additional treatments, such as chemotherapy, may be needed if the surgery was performed for cancer.
• Long-Term Adjustments – Depending on the extent of the surgery, lifelong changes in diet, medication, and lifestyle may be necessary. Support from healthcare providers ensures a smoother transition to post-surgical life.

Recovery takes time, and ongoing medical support helps in adapting to changes and maintaining overall health.

A pancreatectomy is a major surgical procedure, and like any surgery, it carries potential risks and complications. These may occur during or after the operation and can vary depending on overall health, the extent of the surgery, and how well the body responds to treatment.

• Infection – Any surgical procedure carries a risk of infection at the incision site or within the abdomen. Antibiotics and proper wound care help reduce this risk.
• Bleeding and Blood Clots – Excessive bleeding can occur during or after surgery. In some cases, blood transfusions may be required. Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism) are also possible but can be prevented with early movement and medication.
• Digestive Issues – The removal of part or all of the pancreas can affect digestion. Patients may experience nausea, diarrhoea, or difficulty absorbing nutrients. Enzyme supplements and dietary adjustments help manage these issues.
• Diabetes – The pancreas plays a crucial role in blood sugar regulation. If a large portion of the entire pancreas is removed, diabetes may develop, requiring lifelong insulin therapy and blood sugar management.
• Delayed Stomach Emptying (Gastroparesis) – Some patients may experience slow stomach emptying after surgery, leading to bloating, nausea, and discomfort. This condition usually improves over time with dietary modifications and medication.
• Anastomotic Leak – When parts of the digestive system are reconnected, there is a risk of leakage at the surgical site. This can lead to infection and may require additional medical intervention.
• Weight Loss and Malnutrition – Changes in digestion can lead to unintentional weight loss and nutrient deficiencies. A well-planned diet and nutritional supplements help prevent these complications.

Regular follow-ups with the medical team help in identifying and managing potential complications early, ensuring a smoother recovery process.

1. How long does it take to fully recover from a pancreatectomy?

Recovery time varies, but most patients take several months to regain full strength. The exact duration depends on the type of pancreatectomy performed, overall health, and post-surgical care.

2. Will a special diet be required after surgery?

Yes, dietary modifications are often needed to aid digestion and prevent malnutrition. A nutritionist provides personalised guidance on foods to eat and avoid.

3. Can a person live a normal life after a pancreatectomy?

Many patients adapt well to life after surgery with the right medical support, lifestyle changes, and, if necessary, enzyme or insulin therapy. Regular follow-ups help in managing long-term health.

4. Is pancreatectomy always the first treatment option?

Surgery is usually considered when other treatments are not effective or when the condition is severe. In some cases, medications, endoscopic procedures, or lifestyle changes may be explored before surgery is recommended.

5. Will the surgery affect the immune system?

If the spleen is removed along with the pancreas, immunity may be affected. In such cases, vaccines and preventive measures are recommended to reduce infection risks.

6. How soon can normal activities be resumed after surgery?

Light activities can be resumed within a few weeks, but strenuous activities should be avoided until the doctor gives clearance. Full recovery may take several months.

7. Does a pancreatectomy cure pancreatic cancer?

The effectiveness of surgery depends on the stage and type of cancer. In some cases, additional treatments such as chemotherapy or radiation may be needed to improve outcomes.

8. Are there any alternatives to pancreatectomy?

Alternatives depend on the underlying condition. Some patients may be treated with medications, endoscopic procedures, or other surgical techniques that preserve more of the pancreas.

9. How is pain managed after surgery?

Pain is controlled with medications, which may include opioids, nerve blocks, or other pain management techniques. The medical team adjusts pain relief strategies based on recovery progress.

10. Can a pancreatectomy be reversed?

No, the procedure is permanent. Once the pancreas or a portion of it is removed, it cannot be replaced or restored. However, treatment options are available to help manage the body's functions after surgery.

Reviewed by Dr. Nikhil Agrawal, Senior Director, Surgical Oncology, Cancer Care / Oncology, Gastrointestinal & Hepatobiliary Oncology, Gastro Intestinal & Hepatopancreatobiliary Surgical Oncology, Robotic Surgery on 19 March 2025.