Enucleation of Pancreatic Tumors

What are Pancreatic Tumors?

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 tumor is an abnormal growth of cells in the pancreas. Pancreatic tumors prevent the pancreas from functioning effectively. Depending on the cells involved, the tumor 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 esophagus) and diabetes.

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

How are Pancreatic Tumors Treated?

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

Surgery involves the removal of the tumor 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 cancer spreads beyond the pancreas. This affects the normal functioning of the pancreas as well as the other organs.

What is Enucleation of Pancreatic Tumors?

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

Indications for Enucleation of Pancreatic Tumors

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

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

Preparation for Enucleation of Pancreatic Tumors

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

Once pancreatic tumors 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 tumor. You will be given a general anesthetic.

Procedure of Enucleation of Pancreatic Tumors

Enucleation of pancreatic tumors 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 tumor cells into nearby healthy tissues.
The tumor will be removed using specialized surgical tools, along with a very thin margin between the tumor and healthy pancreatic tissue.
A sample of the tumor 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 Tumor

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, diarrhea 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 the 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 Tumors

The advantages of enucleation of pancreatic tumors include:

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

Risks and Complications of Enucleation of Pancreatic Tumors

Enucleation of pancreatic tumors may lead to:

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