Distal Pancreatectomy: Procedure, Indications, and the Role of Ultrasonic Scalpel | Surgsci

A distal pancreatectomy is a surgical procedure that involves the removal of the body and tail of the pancreas. The pancreas is an organ located in the abdomen, behind the stomach, and plays a crucial role in digestion and blood sugar regulation.

This surgery is typically performed when a patient has a tumor in the body or tail of the pancreas. Tumors pose a risk of spreading to other parts of the body, and removing them from the pancreas helps reduce that risk. Other conditions that may necessitate a distal pancreatectomy include acinar cell tumors, adenocarcinoma, ampullary cancer, cancer in the lower part of the bile duct, chronic pancreatitis, duodenal cancer, inflammation, and neuroendocrine tumors.

The procedure for a distal pancreatectomy involves making an incision to expose the pancreas and spleen clearly. The surgeon then explores these organs and decides how much to remove. The remaining part of the pancreas is closed with sutures (stitches) or staples1. The surgery usually takes 2 to 4 hours.

The use of an ultrasonic scalpel in distal pancreatectomy has several advantages. An ultrasonic scalpel is a surgical instrument that uses ultrasonic vibrations to cut through tissue and coagulate blood vessels simultaneously. This technology has been found to reduce the incidence of pancreatic fistula, a significant complication of distal pancreatectomy with a rather high incidence. Pancreatic fistula occurs when pancreatic fluid leaks from the pancreas, which can lead to serious complications such as infections and bleeding.

Furthermore, using an ultrasonic scalpel without any clamping or parenchymal suturing may reduce damage to the remnant pancreas. This is crucial because even though part of your pancreas will be removed during your surgery, there’s usually enough of it left after your surgery to make hormones (insulin and glucagon) and enzymes.

In conclusion, a distal pancreatectomy is a vital surgical procedure for treating tumors and other conditions in the body or tail of the pancreas. The use of an ultrasonic scalpel in this procedure offers significant benefits, including reducing complications and preserving pancreatic function.