Pancreatic Surgery at Stanford
When patients require surgery to address pancreatic disease symptoms, Stanford surgeons carefully assess the patient’s situation to determine which surgical approach will be the most effective and cause the patient the least amount of discomfort and recovery time.
We have deep expertise in the entire spectrum of pancreatic surgery for benign and malignant disease within the Department of Surgery at Stanford University. Stanford is consistently among the top five medical centers in California with respect to the volume of pancreas operations performed annually.
Stanford surgeons are renowned in their field for offering innovative procedures that offer patients a short recovery time.
Pancreatic surgical procedures include:
- Minimally invasive pancreatic resections
- Spleen-preserving pancreatectomy
- Enucleation of pancreatic tumors
- The Whipple
- Innovative treatment of acute pancreatitis
- Surgery for chronic pancreatitis
- Minimally invasive pancreatic resections: Stanford surgeons are leaders in minimally invasive (also called laparoscopic) pancreatic resections. Laparoscopic surgery allows the surgeon to access the abdomen via a number of small "keyhole" incisions (less than one centimeter each). Many patients with pancreatic cysts that require surgery are candidates for this approach, which offers smaller incisions, shorter hospitalization (typically 2 days), less pain, and a faster return to work and life.
- Spleen-preserving pancreatectomy: Stanford surgeons have the largest experience in North America in laparoscopic spleen-preserving pancreatectomy. In a traditional "distal" pancreatectomy (removing the tail/left side of the gland), the spleen is removed with the pancreas because the major splenic blood vessels run through the tail of the pancreas itself. However, in cases of pancreatic surgery for benign disease (e.g., pancreatic cysts), resection of the spleen is not required as a portion of the operation itself, but is typcially removed because of its anatomic proximity alone. Splenic-preservation is a technically demanding technique in which the blood supply to the spleen is carefully preserved so that it can be left behind, preserving the immunologic function of the spleen and reducing the risk of long-term infectious complications.
- Enucleation of pancreatic tumors: A subset of benign or low-grade pancreatic tumors can be safely enucleated (carefully scooped out of the pancreas with a razor thin margin between tumor and pancreas) rather than requiring more extensive surgical removal of a portion of the pancreas. This strategy is technically demanding, but preserves pancreatic tissue and function.
- The Whipple: The "Whipple" is perhaps the most famous/infamous pancreatic operation. This complex operation involves removal of the head of the pancreas, duodenum (first portion of the small bowel), bile duct, gallbladder, and sometimes a small portion of the stomach. The pancreas, stomach, and bile ducts are reattached to the bowel to allow normal digestion of food following recovery. Stanford surgeons have considerable expertise in performing this operation. After the Whipple, our patients stay a median of only 8 days in the Stanford hospital and have very low rates of complications similar to other very high volume university medical centers.
- Innovative approaches in cases of acute pancreatitis: Acute pancreatitis is a life-threatening disease in which the pancreas can actually digest itself and occasionally becomes infected. These cases often require removal of the diseased tissue. The traditional approach is a large open "necrosectomy" (debridement of the pancreas). At Stanford we can often avoid these large and very complex operations. Various less invasive techniques can be performed. These include the laparoscopic transgastric approach (laparoscopic surgery within the lumen of the stomach itself to remove the diseased tissue and connect the stomach to the pancreas to allow ongoing drainage of the pancreas into the stomach). Another novel technique is referred to as "MIRP" (Minimally Invasive Retroperitoneal Pancreatectomy): the dead pancreas is surgically removed through a single 1.5 cm tube through the patient's side using a special operating endoscope.
- Surgery for chronic pancreatitis: A subset of patients with chronic pancreatitis develop calcified "stones" within the pancreatic duct itself that block the flow of pancreatic juice, causing the patient to suffer pain and progressively lose pancreatic tissue and function. Many of these patients are candidates for a variety of pancreatic operations to remove the stones and "re-plumb" the pancreas to allow unimpeded flow of digestive juice into the bowel. This typically provides significant symptom relief and helps preserve pancreatic tissue and function.
We work closely with the GI Pain Clinic to serve patients who suffer from pain arising from pancreatic disorders.