Pancreatic Surgery

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.

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)

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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