What is distal pancreatectomy?
During the operation, the tail of the pancreas, or the tail together with the body, is removed.
Depending on the nature of the disease, the operation may be performed:
- *with preservation of the spleen* (for benign and some precancerous lesions)
- *with removal of the spleen (splenectomy)* — for malignant tumors or when the extent of the disease requires it
For cancer, a regional lymph node dissection is performed at the same time.
Our approach
At MSI, pancreatic tumors are treated in line with guidelines from the *NCCN, ESMO, and ISGPS (International Study Group of Pancreatic Surgery)*.
Before surgery, the disease is fully staged, including multiphase CT or MRI, laboratory tests, tumor markers, and, when indicated, endoscopic ultrasound or biopsy.
We aim to preserve as much pancreatic and splenic function as possible when this is oncologically safe.
*When technically feasible and oncologically safe, we aim to perform distal pancreatectomy laparoscopically.* The minimally invasive approach reduces surgical trauma and postoperative pain and speeds up recovery.
Postoperative care follows the principles of *ERAS (Enhanced Recovery After Surgery)*.
When is surgery needed?
Distal pancreatectomy is performed for:
- cancer of the body or tail of the pancreas
- neuroendocrine tumors
- mucinous cystic neoplasm (MCN)
- solid pseudopapillary neoplasm (SPN)
- certain IPMNs
- symptomatic or potentially malignant cysts
- certain benign tumors
- chronic pancreatitis (in selected cases)
Indications for surgery
Surgery is recommended for:
- localized tumors of the body or tail of the pancreas
- precancerous cystic lesions
- benign tumors that cause symptoms or are at risk of growth
- no distant metastases in malignant disease
How is the operation performed?
The procedure is performed under general anesthesia.
After the pancreas is mobilized, its body and/or tail is resected. In benign disease, the spleen and its vessels are preserved whenever possible. For malignant tumors, the standard is distal pancreatectomy with splenectomy and regional lymph node dissection.
The removed specimen is sent for histopathological examination.
Advantages of laparoscopic surgery
- Performed laparoscopically whenever possible
- Less surgical trauma
- Less postoperative pain
- Faster recovery
- Lower risk of wound complications
- Shorter hospital stay
- The option of preserving the spleen in appropriately selected patients
- Adherence to international oncology standards
Recovery after surgery
Postoperative treatment follows *ERAS* principles. Eating is resumed gradually, and pancreatic function and blood glucose are monitored.
If the spleen is removed, patients receive recommendations on vaccination and further follow-up. If necessary, enzyme replacement therapy is prescribed.
Our advantages
- Specialization in pancreatic surgery
- A commitment to laparoscopic surgery when it is safe and oncologically justified
- Preserving the spleen whenever possible in benign disease
- Use of modern pancreatic surgery techniques
- Adherence to NCCN, ESMO, and ISGPS guidelines
- A multidisciplinary approach to treatment
- Enhanced recovery program (ERAS)
Frequently Asked Questions
No. In benign and some precancerous conditions, we perform the operation with preservation of the spleen whenever possible. For malignant tumors, the standard is distal pancreatectomy with splenectomy and lymph node dissection.
Yes. When indicated and oncologically safe, we aim to perform distal pancreatectomy laparoscopically.
Some patients may need enzyme replacement therapy after resection. This is decided individually during postoperative follow-up.
Yes. If a splenectomy is performed, vaccination against the main encapsulated bacteria is recommended in line with international guidelines.
For malignant tumors, further treatment is decided based on the histopathology results and the multidisciplinary team's recommendation.