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Pancreatectomy

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Pancreatectomy

In medicine, a pancreatectomy is the surgical removal of all or part of the pancreas. Several types of pancreatectomies exist, including pancreaticoduodenectomy (Whipple procedure), distal pancreatectomy, segmental pancreatectomy, and total pancreatectomy.

Pancreatic surgeries have been reported as early as the 1800s, however the first successful complete pancreatectomy was reported in 1944. Surgery on the pancreas is complex, at times requiring both the resection, or removal of parts or the entire organ, as well as anastomosis, or the connection of different parts of the digestive system. Advances in technology have allowed for the improvement in outcomes, reduction of complications, and improvement in surgical techniques.

The pancreas is a digestive and endocrine organ that serves as a gland. It releases endocrine and exocrine hormones to help with metabolism and digestion.

The pancreas is located behind the stomach. It is divided into the head, neck, body and tail. Some people have a fifth part of the pancreas known as the uncinate process. The pancreas contains a main pancreatic duct where the exocrine molecules collect and then drain into the duodenum via the common bile duct. There is also an accessory pancreatic duct that drains above the main duct straight into the duodenum.

Blood supply to the pancreas comes from the celiac artery and the superior mesenteric artery, branches of the aorta.

The pancreas releases digestive enzymes into the gastrointestinal tract via the pancreatic ducts. These enzymes make it possible to break down food and materials in the small intestine allowing nutritional molecules to be absorbed. The enzymes include trypsin and chymotrypsin which help digest proteins, amylase which breaks down carbohydrates, as well as lipase which breaks down fats. The pancreas has majority exocrine function.

The pancreas is also made up of areas of cells known as pancreatic islets which include alpha, beta, and delta cells. Alpha cells secrete glucagon, beta cells secrete insulin, and delta cells secrete somatostatin, all of which are important hormones for metabolism. The endocrine function of the pancreatic glands is only 1-2% of pancreatic function.

Pancreatectomies may be performed for a variety of reasons, including:

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