Surgery

Distal Pancreatectomy

Surgery for tumors in the body or tail of the pancreas — often performed minimally invasively.

What Is a Distal Pancreatectomy?

Diagram showing what is removed in a distal pancreatectomy
Simplified diagram of the distal pancreatectomy showing the resected body and tail of the pancreas and spleen.

A distal pancreatectomy removes the body and tail of the pancreas — the portions to the left of the portal vein. It is the standard surgery for tumors located in these areas, including pancreatic adenocarcinoma, neuroendocrine tumors, and selected cystic lesions.

Unlike the Whipple procedure, distal pancreatectomy does not require reconstruction of the digestive tract. The remaining head and neck of the pancreas continues to produce digestive enzymes and insulin. Recovery is generally faster than after a Whipple.

What Is Removed

The following structures are typically removed:

Body and tail of the pancreasThe portion of the pancreas to the left of the superior mesenteric vein, where the tumor is located.
SpleenThe spleen shares its blood supply with the tail of the pancreas and is routinely removed along with the pancreas for cancer operations. In selected benign cases, a spleen-preserving approach may be possible.
Regional lymph nodesRemoved to determine the extent of spread and ensure complete resection.

Surgical Approaches

Distal pancreatectomy can be performed open, laparoscopically, or robotically. Minimally invasive approaches are used whenever feasible and are associated with less blood loss, shorter hospital stay, and faster return to normal activity.

LaparoscopicSeveral small incisions allow a camera and instruments to remove the pancreas and spleen without a large open incision.
RoboticA robotic platform provides enhanced visualization and precision, particularly useful when dissecting near major blood vessels.
OpenUsed when tumors are large, involve major vessels, or when minimally invasive conversion is required for safety.

What to Expect

In the Hospital

Hospital stay is typically 4–7 days for minimally invasive surgery and 5–9 days for open surgery. A drain is left near the pancreatic stump to monitor for fluid leaks (pancreatic fistula). Diet is advanced from liquids to regular food over a few days.

At Home

Full recovery takes approximately 4–6 weeks. Fatigue and dietary changes are the most common challenges. Pancreatic enzyme replacement may or may not be needed depending on how much of the pancreas remains.

After Splenectomy

Because the spleen plays a role in immunity, patients who have had it removed are at increased risk for certain bacterial infections. Vaccinations against encapsulated bacteria (pneumococcus, meningococcus, Haemophilus influenzae) are given before or shortly after surgery.

After Recovery

Adjuvant chemotherapy is recommended for most patients after distal pancreatectomy for cancer, beginning 4–8 weeks post-operatively. Follow-up CT scans every 3–6 months monitor for recurrence.

Questions About Distal Pancreatectomy?

Dr. Correa performs distal pancreatectomy — including minimally invasive and robotic approaches — at Mount Sinai in New York City.

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