In the surgery in the digestive system, the removal of the body and tail of the pancreas is a difficult and complex surgery because it involves many large blood vessels. When cutting if the stitches are not good, there is a risk of pancreatic fistula, the enzymes lose control leading to the decomposition of neighboring tissues.
1. Cut the torso and tail of the pancreas in which case is it contrained?
After monitoring the test results, the doctor will perform a pancreatic torso and tail removal for patients:
- Cancer of the torso or tail of the pancreas.
- Benign lumps of the body or tail of the pancreas are at risk of malice.
- True cyst of the body or tail of the pancreas.
- Rupture of the torso or tail of the pancreas due to injury.
If the patient encounters one of the following cases, the pancreatic body and tail surgery will not be carried out:
- Cancerous mass at stage T4 invades important vascular structures such as upper mesentereal vascular bundles or liver arteries, spleen bundles or peritoneal meta metabolis.
- Patients with peritonitis caused by rupture of the torso or tail of the pancreas arrive late.
- Progressive acute pancreatitis.
- Patients are in a treatment regimen with contrainasive anesthesia or cardiovascular and respiratory diseases with contraintent inflatables in the abdomen.
2. What should pancreatic body and tail removal surgery prepare?
Because it is one of the difficult surgeries, the person who performs must be a hepatic hepatic surgeon with experience in laparoscopic surgery, an experienced anesthesiist.
2.1 Means of use during surgery
- Specialized endoscopic surgical systems and instruments for the abdominal area.
- Hemost control tools include: Ultrasonic cutters or ligasure, bipolar hemost knives, hemolocks.
- Use a straight or foldable extension machine (Flex) using a 60mm white vascular cartridge.
2.2 For patients
- Pre-surgical clinical examination.
- Regular pre-surgical testing.
- Check the risk of surgery as needed.
- Abdominal CT scans with injections or abdominal MRI are contrasting from.
- In some cases for evaluation of the stage of cancer, the patient is in order to perform an ultrasound through a gastroscopy.
- In some cases, patients are prescribed a tumor biosy under the instructions of an ultrasound or CT Scan to determine a pre-surgery diagnosis.
- Prepare the oral colon in case of need.
2.3 Medical records
Administrative procedures to be completed as prescribed: Detailed medical records, consultation minutes, minutes of examination before anesthesia, written guarantee of consent to surgery.
3. What doctors and patients should keep in mind during and after surgery
During surgery to remove the torso and tail of the pancreas, if:
- Large tumours are not capable of laparoscopic surgery, open surgical transfer.
- Patients bleeding a lot uncontrollably through laparoscopic surgery: open surgical transfer.
- The horizontal colon is damaged when the colon is removed: depending on the degree of damage and the condition of the colon can stitch the perforation or open the colon to the skin.
- In case of anemia a horizontal segment of the colon due to damage to the hemline of the colon: monitor the patient's condition to perform a resumpry of the aneous colon or bring the two heads to the skin.
After the doctor undergoes surgery to remove the body and tail of the pancreas in accordance with the medical procedure, the patient needs to be compensated for enough water-electrolysis, daily energy, sufficient infusion of protein, albumin and blood.
Besides, pain relief or antibiotics may be prescribed. Depending on the degree of infection, the period of coordinated antibiotic use needs to be longer. Patients drink sugar water, milk on the first day after surgery, eat early after having mediasted.
The doctor should monitor and handle the following cases:
- Bleeding: Bleeding in the abdomen (monitored through drains, survival marks and blood formula tests): Close monitoring is required to the extent that surgery is required immediately through laparoscopy or open surgery.
- Pancreatic fistula: Monitoring through fluid (color, supply, amylase/fluid test), most conservative treatment cases, re-surgery is in order to be re-operated if a postoperative fistula and pancreatic tail cause an absculsion in the abdomen or peritonitis.
- Post-surgery intestinal obstruction: Rare, monitored and treated as mechanical intestinal obstruction.
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