Skip to main content

Pancreatic Surgery

  • Chapter
  • First Online:
Upper Abdominal Surgery

Abstract

Pancreatic surgery remains a challenging and difficult area of general surgery. Resection for tumors or inflammatory complications anatomically includes the distal pancreatic tail, the head, or complete removal of the entire gland, determined by the nature and extent of the pathology and fitness of the patient. This chapter aims to provide useful information on complications, risks, and consequences of a number of pancreatic surgical procedures. For other associated procedures, refer to the relevant chapter and volume.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Further Readings, References, and Resources

Distal Pancreatectomy

  • Bilimoria MM, Cormier JN, Mun JE, et al. Pancreatic leak after left pancreatectomy following main pancreatic duct ligation. Br J Surg. 2003;90:190–6.

    Article  CAS  PubMed  Google Scholar 

  • Henne-Bruns D, Vogel I, Lüttges J, Klöppel G, Kremer B. Surgery for ductal adenocarcinoma of the pancreatic head: staging, complications, and survival after regional versus extended lymphadenectomy. World J Surg. 2000;24(5):595–601; discussion 601–2.

    Google Scholar 

  • Kremer B, Vogel I, Lüttges J, Klöppel G, Henne-Bruns D. Surgical possibilities for pancreatic cancer: extended resection. Ann Oncol. 1999;10 Suppl 4:252–6.

    Google Scholar 

  • Neoptolemos JP, Stocken DD, Dunn JA, Almond J, Beger HG, Pederzoli P, Bassi C, Dervenis C, Fernandez-Cruz L, Lacaine F, Buckels J, Deakin M, Adab FA, Sutton R, Imrie C, Ihse I, Tihanyi T, Olah A, Pedrazzoli S, Spooner D, Kerr DJ, Friess H, Büchler MW, European Study Group for Pancreatic Cancer. Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial. Ann Surg. 2001;234(6):758–68.

    Google Scholar 

  • Obertop H, Pedrazzoli S. Current views on surgical treatment of pancreatic cancer. Dig Surg. 1999;16(4):263–4.

    Google Scholar 

  • Pedrazzoli S, Liessi G, Pasquali C, Ragazzi R, Berselli M, Sperti C. Postoperative pancreatic fistulas: preventing severe complications and reducing reoperation and mortality rate. Ann Surg. 2009;249(1):97–104.

    Google Scholar 

  • Pedrazzoli S, Michelassi F. Extent of lymphadenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas. J Gastrointest Surg. 2000;4(3):229–30.

    Google Scholar 

  • Pedrazzoli S, Pasquali C, Guzzinati S, Berselli M, Sperti C. Survival rates and cause of death in 174 patients with chronic pancreatitis. J Gastrointest Surg. 2008;12(11):1930–7.

    Google Scholar 

  • Pedrazzoli S, Pasquali C, Sperti C. Role of surgery in the treatment of bilio-pancreatic cancer: the European experience. Semin Oncol. 2002;29(6 Suppl 20):23–30.

    Google Scholar 

  • Pedrazzoli S, Sperti C, Pasquali C. Pancreatic head resection for noninflammatory benign lesions of the head of the pancreas. Pancreas. 2001;23(3):309–15.

    Google Scholar 

  • Sperti C, Pasquali C, Ferronato A, Pedrazzoli S. Median pancreatectomy for tumors of the neck and body of the pancreas. J Am Coll Surg. 2000;190(6):711–16.

    Google Scholar 

  • Sperti C, Pasquali C, Liessi G, Pinciroli L, Decet G, Pedrazzoli S. Pancreatic resection for metastatic tumors to the pancreas. J Surg Oncol. 2003;83(3):161–6; discussion 166.

    Google Scholar 

  • Verslype C, Van Cutsem E, Dicato M, Cascinu S, Cunningham D, Diaz-Rubio E, Glimelius B, Haller D, Haustermans K, Heinemann V, Hoff P, Johnston PG, Kerr D, Labianca R, Louvet C, Minsky B, Moore M, Nordlinger B, Pedrazzoli S, Roth A, Rothenberg M, Rougier P, Schmoll HJ, Tabernero J, Tempero M, van de Velde C, Van Laethem JL, Zalcberg J. The management of pancreatic cancer. Current expert opinion and recommendations derived from the 8th World Congress on Gastrointestinal Cancer, Barcelona, 2006. Ann Oncol. 2007;18 Suppl 7:vii1–10.

    Google Scholar 

  • von Bernstorff W, Voss M, Freichel S, Schmid A, Vogel I, Jöhnk C, Henne-Bruns D, Kremer B, Kalthoff H. Systemic and local immunosuppression in pancreatic cancer patients. Clin Cancer Res. 2001;7(3 Suppl):925s-32.

    Google Scholar 

Pancreaticoduodenectomy (Including Whipple’s Procedure)

  • Birkmeyer JD, Finlayson SR, Tosteson AN, et al. Effect of hospital volume on the in-house mortality of pancreaticoduodenectomy. Surgery. 1999;125:250–6.

    Article  CAS  PubMed  Google Scholar 

  • Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, Welch HG, Wennberg DE. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002;346:1128–37.

    Article  PubMed  Google Scholar 

  • Henne-Bruns D, Vogel I, Lüttges J, Klöppel G, Kremer B. Surgery for ductal adenocarcinoma of the pancreatic head: staging, complications, and survival after regional versus extended lymphadenectomy. World J Surg. 2000;24(5):595–601; discussion 601–2.

    Google Scholar 

  • Kremer B, Vogel I, Lüttges J, Klöppel G, Henne-Bruns D. Surgical possibilities for pancreatic cancer: extended resection. Ann Oncol. 1999;10 Suppl 4:252–6.

    Google Scholar 

  • Lemaire E, O'Toole D, Sauvanet A, Hammel P, Belghiti J, Ruszniewski P. Functional and morphological changes in the pancreatic remnant following pancreaticoduodenectomy with pancreaticogastric anastomosis. Br J Surg. 2000;87(4):434–8.

    Google Scholar 

  • Lowy AM, Lee JE, Pisters PW, et al. Prospective, randomized trial of octreotide to prevent pancreatic fistula after pancreaticoduodenectomy for malignant disease. Ann Surg. 1997;226:632–41.

    Google Scholar 

  • Lüttges J, Vogel I, Menke M, Henne-Bruns D, Kremer B, Klöppel G. The retroperitoneal resection margin and vessel involvement are important factors determining survival after pancreaticoduodenectomy for ductal adenocarcinoma of the head of the pancreas. Virchows Arch. 1998;433(3):237–42.

    Article  PubMed  Google Scholar 

  • Neoptolemos JP, Stocken DD, Dunn JA, Almond J, Beger HG, Pederzoli P, Bassi C, Dervenis C, Fernandez-Cruz L, Lacaine F, Buckels J, Deakin M, Adab FA, Sutton R, Imrie C, Ihse I, Tihanyi T, Olah A, Pedrazzoli S, Spooner D, Kerr DJ, Friess H, Büchler MW, European Study Group for Pancreatic Cancer. Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial. Ann Surg. 2001;234(6):758–68.

    Google Scholar 

  • Nikfarjam M, Kimchi ET, Gusani NJ, Shah SM, Sehmbey M, Shereef S, Staveley-O’Carroll KF. A reduction in delayed gastric emptying by classic pancreaticoduodenectomy with an antecolic gastrojejunal anastomosis and a retrogastric omental patch. J Gastrointest Surg. 2009;13(9):1674–82.

    Article  PubMed  Google Scholar 

  • Obertop H, Pedrazzoli S. Current views on surgical treatment of pancreatic cancer. Dig Surg. 1999;16(4):263–4.

    Google Scholar 

  • Pedrazzoli S, DiCarlo V, Dionigi R, Mosca F, Pederzoli P, Pasquali C, Klöppel G, Dhaene K, Michelassi F. Standard versus extended lymphadenectomy associated with pancreatoduodenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas: a multicenter, prospective, randomized study. Lymphadenectomy Study Group. Ann Surg. 1998;228(4):508–17.

    Article  CAS  PubMed  Google Scholar 

  • Pedrazzoli S, Liessi G, Pasquali C, Ragazzi R, Berselli M, Sperti C. Postoperative pancreatic fistulas: preventing severe complications and reducing reoperation and mortality rate. Ann Surg. 2009;249(1):97–104.

    Google Scholar 

  • Pedrazzoli S, Michelassi F. Extent of lymphadenectomy in the surgical treatment of adenocarcinoma of the head of the pancreas. J Gastrointest Surg. 2000;4(3):229–30.

    Google Scholar 

  • Pedrazzoli S, Pasquali C, Guzzinati S, Berselli M, Sperti C. Survival rates and cause of death in 174 patients with chronic pancreatitis. J Gastrointest Surg. 2008;12(11):1930–7.

    Google Scholar 

  • Pedrazzoli S, Pasquali C, Sperti C. Role of surgery in the treatment of bilio-pancreatic cancer: the European experience. Semin Oncol. 2002;29(6 Suppl 20):23–30.

    Google Scholar 

  • Pedrazzoli S, Sperti C, Pasquali C. Pancreatic head resection for noninflammatory benign lesions of the head of the pancreas. Pancreas. 2001;23(3):309–15.

    Google Scholar 

  • Pisters PW, Hudec WA, Hess KR, et al. Effect of preoperative biliary decompression on pancreaticoduodenectomy-associated morbidity in 300 consecutive patients. Ann Surg. 2001;234:47–55.

    Article  CAS  PubMed  Google Scholar 

  • Ramia JM, de la Plaza R, Quinones JE, Veguillas P, Adel F, Garcia-Parreno J. Gastroenteric reconstruction route after pancreaticoduodenectomy: antecolic versus retrocolic. Cir Esp. 2013;91(4):211–16.

    Article  PubMed  Google Scholar 

  • Schafer M, Mullhaupt B, Clavien PA. Evidence-based pancreatic head resection for pancreatic cancer and chronic pancreatitis. Ann Surg. 2002;236:137–48.

    Article  PubMed  Google Scholar 

  • Schniewind B, Bestmann B, Henne-Bruns D, Faendrich F, Kremer B, Kuechler T. Quality of life after pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head. Br J Surg. 2006;93(9):1099–107.

    Google Scholar 

  • Schniewind B, Bestmann B, Kurdow R, Tepel J, Henne-Bruns D, Faendrich F, Kremer B, Kuechler T. Bypass surgery versus palliative pancreaticoduodenectomy in patients with advanced ductal adenocarcinoma of the pancreatic head, with an emphasis on quality of life analyses. Ann Surg Oncol. 2006;13(11):1403–11.

    Google Scholar 

  • Sperti C, Pasquali C, Ferronato A, Pedrazzoli S. Median pancreatectomy for tumors of the neck and body of the pancreas. J Am Coll Surg. 2000;190(6):711–16.

    Google Scholar 

  • Sperti C, Pasquali C, Liessi G, Pinciroli L, Decet G, Pedrazzoli S. Pancreatic resection for metastatic tumors to the pancreas. J Surg Oncol. 2003;83(3):161–6; discussion 166.

    Google Scholar 

  • Tyler DS, Evans DB. Reoperative pancreaticoduodenectomy. Ann Surg. 1994;219:211–21.

    Article  CAS  PubMed  Google Scholar 

  • Verslype C, Van Cutsem E, Dicato M, Cascinu S, Cunningham D, Diaz-Rubio E, Glimelius B, Haller D, Haustermans K, Heinemann V, Hoff P, Johnston PG, Kerr D, Labianca R, Louvet C, Minsky B, Moore M, Nordlinger B, Pedrazzoli S, Roth A, Rothenberg M, Rougier P, Schmoll HJ, Tabernero J, Tempero M, van de Velde C, Van Laethem JL, Zalcberg J. The management of pancreatic cancer. Current expert opinion and recommendations derived from the 8th World Congress on Gastrointestinal Cancer, Barcelona, 2006. Ann Oncol. 2007;18 Suppl 7:vii1–10.

    Google Scholar 

  • von Bernstorff W, Voss M, Freichel S, Schmid A, Vogel I, Jöhnk C, Henne-Bruns D, Kremer B, Kalthoff H. Systemic and local immunosuppression in pancreatic cancer patients. Clin Cancer Res. 2001;7(3 Suppl):925s–32.

    Google Scholar 

  • Yeo CJ, Cameron JL, Lillemoe KD, et al. Does prophylactic octreotide decrease the rates of pancreatic fistula and other complications after pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Ann Surg. 2000;232:419–29.

    Article  CAS  PubMed  Google Scholar 

  • Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg. 1995;222:580–8; discussion 588–92.

    CAS  PubMed  Google Scholar 

  • Yeo CJ, Cameron JL, Sohn TA, et al. Pancreaticoduodenectomy with or without extended retroperitoneal lymphadenectomy for periampullary adenocarcinoma: comparison of morbidity and mortality and short-term outcome. Ann Surg. 1999;229:613–22; discussion 622–14.

    Article  CAS  PubMed  Google Scholar 

  • Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. Ann Surg. 1997;226:248–57; discussion 257–60.

    Article  CAS  PubMed  Google Scholar 

Open Cyst-Gastrostomy

  • Clemente CD. Anatomy – a regional atlas of the human body. 4th ed. Baltimore: Williams and Wilkins; 1997.

    Google Scholar 

  • Jamieson GG. The anatomy of general surgical operations. 2nd ed. Edinburgh: Churchill Livingston; 2006.

    Google Scholar 

  • Melman L, Azar R, Beddow K, Brunt LM, Halpin VJ, Eagon JC, Frisella MM, Edmundowicz S, Jonnalagadda S, Matthews BD. Primary and overall success rates for clinical outcomes after laparoscopic, endoscopic, and open pancreatic cystgastrostomy for pancreatic pseudocysts. Surg Endosc. 2009;23(2):267–71. Epub 2008 Nov 27.

    Google Scholar 

  • Owera AM, Ammori BJ. Laparoscopic endogastric and transgastric cystgastrostomy and pancreatic necrosectomy. Hepatogastroenterology. 2008;55(81):262–5.

    Google Scholar 

Laparoscopic Cyst-Gastrostomy

  • Melman L, Azar R, Beddow K, Brunt LM, Halpin VJ, Eagon JC, Frisella MM, Edmundowicz S, Jonnalagadda S, Matthews BD. Primary and overall success rates for clinical outcomes after laparoscopic, endoscopic, and open pancreatic cystgastrostomy for pancreatic pseudocysts. Surg Endosc. 2009;23(2):267–71. Epub 2008 Nov 27.

    Google Scholar 

  • Owera AM, Ammori BJ. Laparoscopic endogastric and transgastric cystgastrostomy and pancreatic necrosectomy. Hepatogastroenterology. 2008;55(81):262–5.

    Google Scholar 

Endoscopic Cyst-Gastrostomy

  • Melman L, Azar R, Beddow K, Brunt LM, Halpin VJ, Eagon JC, Frisella MM, Edmundowicz S, Jonnalagadda S, Matthews BD. Primary and overall success rates for clinical outcomes after laparoscopic, endoscopic, and open pancreatic cystgastrostomy for pancreatic pseudocysts. Surg Endosc. 2009;23(2):267–71.

    Google Scholar 

  • Owera AM, Ammori BJ. Laparoscopic endogastric and transgastric cystgastrostomy and pancreatic necrosectomy. Hepatogastroenterology. 2008;55(81):262–5.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Christopher S. Worthley MBBS, DipClinSci, FRACS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag London

About this chapter

Cite this chapter

Worthley, C.S., Coventry, B.J. (2014). Pancreatic Surgery. In: Coventry, B. (eds) Upper Abdominal Surgery. Surgery: Complications, Risks and Consequences. Springer, London. https://doi.org/10.1007/978-1-4471-5436-5_9

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5436-5_9

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5435-8

  • Online ISBN: 978-1-4471-5436-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics