Sydney East Pancreatic Centre

Enucleation of Pancreatic Tumours

What are Pancreatic Tumours?

The pancreas is a gland that has a dual role - it secretes digestive juices and enzymes to assist in digestion (exocrine) and releases insulin to regulate blood sugar levels (endocrine).

A pancreatic tumour is an abnormal growth of cells in the pancreas. Pancreatic tumours prevent the pancreas from functioning effectively. Depending on the cells involved, the tumour can affect its digestive or endocrine function, leading to loss of appetite, sudden weight loss, abdominal pain, jaundice, changes in bowel movements, indigestion, gastroesophageal reflux (stomach contents flow back into the oesophagus) and diabetes.

Pancreatic tumours can become dangerous if they spread to other parts of the body. Therefore, early diagnosis and treatment is essential to prevent further complications.

How are Pancreatic Tumours Treated?

Pancreatic tumours can be treated by various methods such as chemotherapy, hormone therapy, surgery, targeted therapy and chemoembolization.

Surgery involves the removal of the tumour along with a margin of healthy tissue. Sometimes, nearby organs such as the spleen, gallbladder, and parts of the stomach and small intestine may also be removed when the cancer spreads beyond the pancreas. This affects the normal functioning of the pancreas as well as the other organs.

What is Enucleation of Pancreatic Tumours?

Enucleation of pancreatic tumours is a less extensive surgical technique in which certain types of low-grade or benign pancreatic tumours are removed with a minimal margin of the healthy pancreatic tissue, thus preserving maximum healthy tissue for optimal functioning.  

Indications for Enucleation of Pancreatic Tumours

The enucleation procedure is recommended for removal of small tumours with a maximum diameter of 2 cm under the following conditions:

  • Intraductal papillary mucinous neoplasms (IPMNs): tumours of the pancreatic duct
  • Benign endocrine tumours: tumours developing from the hormone-producing pancreatic cells
  • Pancreatic cystic lesions

Preparation for Enucleation of Pancreatic Tumours

Diagnosis will be based on your medical history, physical examination and the results of your blood tests and tumour marker test. Magnetic resonance imaging (MRI), abdominal ultrasound, endoscopy, laparoscopy or biopsy may also be performed for confirmation.

Once pancreatic tumours are confirmed, the area to be operated will be marked. You may have to lie on your side or on your back depending on the position of the tumour. You will be given a general anaesthetic.

Procedure of Enucleation of Pancreatic Tumours

Enucleation of pancreatic tumours involves the following steps:

  • A small cut will be made, and the underlying tissues separated. Your surgeon may place non-resorbable sutures on the abdomen to prevent bleeding and leakage of tumour cells into nearby healthy tissues.
  • The tumour will be removed using specialised surgical tools, along with a very thin margin between the tumour and healthy pancreatic tissue.
  • A sample of the tumour is frozen and analyzed microscopically to confirm that it is benign and hasn’t spread to other parts.
  • The incision will be closed with resorbable sutures and a sealant.

Recovery after Enucleation of Pancreatic Tumour

You may be required to stay in the hospital for 7 to 11 days.

  • You will be prescribed medications to manage pain.
  • Sit upright, try moving around or take short walks as soon as you are comfortable after your surgery to keep your chest clear and prevent bed sores, stiffness and constipation.
  • You may develop irregular bowel movements and symptoms such as stomach pain, diarrhoea or gas. It is normal and should subside with time.
  • You may have difficulty eating for a few days and may be fed intravenously or through a feeding tube.
  • You may resume eating after your doctor’s approval. You will be given special instructions on foods that are safe to eat and foods you need to avoid.
  • It is recommended to have frequent small meals every three hours and drink fluids between meals to prevent dehydration.
  • Complete recovery may take up to two months.

Advantages of Enucleation of Pancreatic Tumours

The advantages of enucleation of pancreatic tumours include:

  • Preserves the pancreatic tissue and its functioning
  • Reduced blood loss
  • Shorter operation time
  • Shorter hospital stay
  • Faster recovery
  • Lesser need for revision surgeries

Risks and Complications of Enucleation of Pancreatic Tumours

Enucleation of pancreatic tumours may lead to:

  • Pancreatic fistula (damage to pancreatic ducts causing leakage of pancreatic secretions)
  • Post-surgery bleeding
  • Infection
  • Damage to adjacent nerves or tissues
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