Pancreatic Procedures Performed by Dr. Fraiman
With over 20 years of highly-specialized experience, Dr. Mark Fraiman has become an expert pancreatic surgeon in Baltimore, MD. His procedures include:
- Whipple Procedure
- Open and Laparoscopic distal pancreatectomy
- Chronic Pancreatitis surgery (Puestow procedure and Frey procedure)
- Pancreatic debridement for necrotizing acute pancreatitis
Surgical resection of the pancreas provides the best chance for a complete cure and offers a better overall prognosis compared to medical therapy for pancreatic conditions. This is the main reason why we put so much effort into giving pre-operative testing to try and identify those patients who may be good candidates for surgery.
Below are the main pancreatic procedures performed by Dr. Fraiman.
Pancreas Removal Surgery: Whipple Procedure
The Whipple procedure, commonly referred to as pancreaticoduodenectomy, is used to treat cancer of the pancreas. It is generally performed when the cancer is confined to the head of the pancreas and if the patient is in perfect health to withstand a major operation.
In the Whipple procedure, the surgeon takes out the head of the pancreas affected by cancer, a portion of the duodenum, sometimes the gallbladder, the first part of the small intestine and part of the stomach. The surgeon then connects the remaining pancreas, intestine and bile duct, so contents of the stomach will flow into the small intestine to allow for digestion.
The operation usually lasts for five to seven hours, and the goal is to completely remove the tumor and give you the best chance for a complete cure. After a Whipple procedure, patients are hospitalized for up to seven days to allow our surgeons to monitor their progress closely.
Open and Laparoscopic Distal Pancreatectomy
Distal pancreatectomy is used to treat tumors that are found within the body or tail-end of the pancreas. This surgical procedure involves removing the affected portion of the body or tail-end of your pancreas while leaving the head intact. The surgeon will usually also remove the spleen because it is located next to the tail of the pancreas.
Even though the distal pancreatectomy is not as complicated as the Whipple procedure, it is still a major surgery. This is because the spleen is part of your immune system, and, if removed, you’ll be on antibiotics for the rest of your life to prevent complications.
While this procedure is often performed using open surgery methods, Dr. Fraiman and the surgical team at St. Joseph’s Medical Center can perform distal pancreatectomy laparoscopically. This involves the use of small cameras to make incisions the size of a keyhole to reduce trauma and blood loss and initiate faster recovery times.
Chronic Pancreatitis Surgery: (Puestow and Frey Procedures)
Puestow vs Frey Procedures
Both the Puestow and Frey’s procedures are surgical techniques used to treat chronic pancreatitis. During a Frey’s procedure, the diseased parts of the pancreas are removed to expose the main pancreatic duct found in the head of the pancreas. A loop of the jejunum (last part of small intestine) is then attached to the exposed pancreatic duct to improve drainage in the pancreas. The main goal of a Frey surgery is to allow for better drainage in the head of the pancreas.
In the Puestow procedure, the pancreas is filleted along its axis from the head to the tail and connected to a loop in the jejunum to allow for drainage. One advantage of the Puestow procedure over the Frey’s procedure is that the pancreas is preserved, which is of great importance to patients with endocrine and exocrine insufficiency because of chronic pancreatitis.
Pancreatic Debridement for Necrotizing Acute Pancreatitis
Acute pancreatitis causes death to parts of the pancreas. The dying pancreas releases enzymes which cause further death to the fatty tissues in the abdomen. As a result, acute pancreatitis causes the death of the pancreatic tissue as well as the death of the fatty tissues around the pancreas.
This process is called pancreatic necrosis. The surgery that is performed to take out the dead tissue is called debridement of the pancreatic necrosis. In this surgery, all dead and necrotic tissue within and outside the pancreas is removed.
Our surgeons use a CT scan to plan for the surgery and identify all the areas that have a necrotic or dead tissue so that they can be safely removed. The operation usually lasts for four to five hours, and the main aim of this acute pancreatitis surgery is to completely remove all dead tissue and relieve pain.
Contact Our Pancreas Specialists Today
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Common Patient Questions:
Pancreas surgery may be necessary if you struggle with chronic pancreatitis or your doctor has discovered pancreatic tumors. Surgery offers many patients with pancreas issues significant pain relief, enhanced quality of life and even a cure or better overall prognosis.
If your doctor has recommended a pancreas procedure, you undoubtedly have many concerns. Check out these frequently asked questions to help you feel more familiar with your options.
You can live without your pancreas. However, removing this important organ means that you’ll have to carefully manage many aspects of your health and digestion. Without the pancreas, your body can no longer make insulin and other hormones that regulate blood sugar. You will develop diabetes, which requires you to take insulin. The pancreas also creates enzymes that aid digestion, so you must take enzyme pills to help this process.
Short-term side effects of the surgery to have your pancreas removed include pain and nausea. However, some patients experience longer-term side effects of pancreas removal, including:
- Problems with digestion
- Diabetes
- Occasional pain in the stomach area
- Nutritional deficiencies
- Changes in bowel habits
- Fatigue
The type of surgery you undergo determines how long the procedure will take. On average, pancreas surgery takes anywhere from two to six hours to complete.
The amount of removal depends on your condition and the type of surgery being performed. The Whipple procedure involves removing a portion of the pancreas and small intestine, sometimes the gallbladder and part of the stomach if needed. However, in a total pancreatectomy, surgeons remove the entire pancreas.
No, the pancreas does not grow back after surgery.
While pancreatitis causes distinct symptoms, pancreatic cancer is often difficult to catch in its earliest stages. However, if you experience some or all of the following symptoms, it’s time to seek help:
- Upper abdominal pain
- Tenderness when touching your abdomen
- Abdominal pain that radiates to your back
- Low fever
- Nausea or vomiting
- Rapid pulse
You can expect to be in the hospital for several days following your surgery. However, patients with more complicated cases may have to stay for a couple of weeks. Your medical team will get you up and moving within a day and monitor you for any complications or digestive issues. Once you’re home, full recovery usually takes two to six months.
Although it may take around three months to regain your full strength, many patients return to work and their normal routine in about one month.
If you struggle with pancreas issues or need a second opinion on a diagnosis, we invite you to visit Dr. Mark Fraiman. As one of the premier pancreatic cancer surgeons and treatment providers in Towson, Maryland, Dr. Fraiman is proud to bring his expertise to patients throughout the Baltimore area.
For advanced treatment options for pancreatic cancer, pancreatitis and more, contact Dr. Fraiman and the multidisciplinary team at The Liver and Pancreas Center in Towson, Maryland, today.
Check Out Related Resources:
Whipple Procedure Complications
Best Foods to Eat for Your Pancreas
