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Friday, July 2, 2010

Distal or caudal pancreatectomy

  • When the tumor is located in the left side of the pancreas, a distal or caudal pancreatectomy is considered. Often the tumors that arise in the left region of the pancreas are diagnosed at a very late stage when metastasis has already occurred.
  • Resection is a possibility only if the tumor is localised and the celiac axis, the superior mesenteric arteries are not involved. Involvement of splenic vessels is not a contraindication for resection.
  • The entire pancreatic body and tail has to be assessed along with the assessment of celiac axis, periaortic region and the peritoneum.
  • The spleen is resected in most of the cases after ligating the splenic artery: removal of the spleen assists dissection of the tail. In small and more indolent tumors, spleen resection is a well described procedure with documented benefits.
  • The left sided tumors are typically larger in size and lymph nodes are involved to a lesser extent as compared to the right sided tumors.

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