A distal pancreatectomy is the removal of the end of the pancreas while leaving the pancreatic head attached. It is performed to treat pancreatic cancer localized in the end of the pancreas, but may also be used for chronic pancreatitis, pancreatic pseudocysts, and injury due to trauma. When the disease affects the splenic artery or vein, the adjacent spleen is often removed.
After removal of the end of the pancreas, the remaining portion of the organ functions normally by producing and releasing digestive enzymes and hormones. Compared to surgical procedures that remove the head of the pancreas, a distal pancreatectomy is performed in much less time and requires a shorter recovery period. The procedure can also be performed using laparoscopic instruments. Usually, patients undergo radiation therapy or chemotherapy in addition to the surgical procedure.
Tumors in the tail of the pancreas are removed with a distal pancreatectomy. In cases of cancer, the tumor often invades the splenic artery or vein. In addition, cancers in this location can spread to the lymph nodes in the hilum of the spleen. For these reasons, it is frequently best to remove the spleen along with the tail of the pancreas.
The pancreatic duct and cut edge of the pancreas is oversewn in an effort to prevent any leak of pancreatic juice.