Suite 411, Netcare Unitas / Suite 206, Midstream Mediclinic
TOTAL PANCREATECTOMY
REMOVING YOUR WHOLE PANCREAS, YOUR DUODENUM, A SMALL PORTION OF YOUR STOMACH, THE GALLBLADDER AND PART OF YOUR BILE DUCT, YOUR SPLEEN AND MANY OF THE SURROUNDING LYMPH NODES.

Indications:

This operation is indicated for certain diseases of the pancreas, mainly pancreatic cancer, and other benign and non-benign tumours.

Procedure:

This is very major surgery. It involves removing your whole pancreas, your duodenum, a small portion of your stomach, the gall bladder and part of your bile duct, your spleen and many of the surrounding lymph nodes.

As you will not have any pancreas left after this operation, you will need life-long insulin injections to manage your diabetes. Furthermore, you will need enzyme supplementation, which involves taking a tablet before every meal to assist your digestive system to break-down and absorb some of the nutrients in the food you eat. Getting over this type of surgery is hard work. It will take time to get back to eating normally and regaining your strength.

Make sure you discuss the possible complications with your surgeon and ask all the questions you need to ask. It is important that your family members are given the chance to talk things through with the surgeon as well. The most common complications and the risk for developing them are:

  • Bleeding 5% – You may have bleeding shortly after your operation because a blood vessel tie is leaking or because your blood is not clotting properly. The manner in which the bleeding episode is treated depends on what is causing it and may involve going back to the operating room for a further operation to control the bleeding site.
  • Leak or fistula 10-15% – A ‘fistula’ is an opening. In this case, it means that part of the internal stitching to the digestive system has come apart or broken down. This results in some of the digestive juices and bacteria entering the abdominal cavity and resulting infection. Drains put in during the operation will be left in until the leak dries up. The leak often heals on its own. Sometimes surgery is needed to repair the leak.
  • Infection 25% – Infection can develop because there is blood or tissue fluid collecting internally around the operation site or because there is internal bleeding. If you develop an internal infection, you will be given antibiotics through your drip. Abscesses or any fluid that has collected internally will need to be drained.
  • Draining an abscess is usually performed by putting in a drainage tube. The needle or tube is often guided into place under X-ray or ultrasound guidance, but repeat surgery is sometimes necessary for adequate drainage.
  • Chest infection is a common complication of many operations. It happens because you are not moving around enough or breathing deeply enough after your operation. What is normally coughed up stays in the lungs and becomes a focus for infection. You can help prevent this from developing by diligently doing your deep breathing exercises and becoming mobile as soon as possible. The physiotherapists and nurses will help you to mobilize early which helps the lungs to expand better and prevent lung complications.

After your consultation:

  • Obtain authorization from your medical aid and book your bed for your hospital admission.
  • Carefully read through pre-operative information provided.

Day before surgery:

  • Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist  (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).

Day of surgery:

  • Arrive for admission at indicated time on ‘Code & Consent’ sheet.
  • Change into theatre attire, remove all valuable belongings.

The time the procedure takes varies but is in most cases between 6-10 hours in duration.

Duration of hospital stay:

  • Usually 5 – 10 days (dependent on post-operative progress)

Activities:

  • Refrain from strenuous activities (incl. exercise) for at least 4 weeks post-operatively

Back to work:

  • Sick leave required post-operatively is approximately 3 – 4 weeks in total

Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:

  • Warming devises in theatre as well as warm intravenous fluids.
  • Intra-operative pain medication through the drip.
  • Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
  • As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.
If you experience any worrisome problems, please contact the rooms during working hours or the emergency number (012) 333 6000 after hours.

More procedures performed by Dr Basson & Jeske

ABSCESS DRAINAGE
ABSCESS DRAINAGE

A SKIN INCISION IS MADE AND THE CONTENTS OF THE ABSCESS IS DRAINED.

ADRENALECTOMY (OPEN/LAPAROSCOPIC)
ADRENALECTOMY (OPEN/LAPAROSCOPIC)

AN OPERATION TO REMOVE ONE (OR BOTH) ADRENAL GLANDS.

ANAL FISTULECTOMY
ANAL FISTULECTOMY

THE FISTULA TRACT IS IDENTIFIED AND IS OPENED ALONG ITS LENGTH, AND THE EXPOSED INSIDE OF THE TRACT IS THEN CLEANED OUT.

APPENDISECTOMY (LAPAROSCOPIC/OPEN)
APPENDISECTOMY (LAPAROSCOPIC/OPEN)

AN OPERATION TO REMOVE AN APPENDIX THAT IS INFLAMED/SWOLLEN/HAS RUPTURED/HAS FORMED AN ABSCESS.

BILE DUCT EXPLORATION
BILE DUCT EXPLORATION

THE COMMON BILE DUCT (CBD – THE MAIN TUBE CARRYING BILE FROM THE LIVER TO THE INTESTINE) IS OPENED UP. ANY GALLSTONES WITHIN THE DUCT CAUSING A BLOCKAGE CAN BE REMOVED.

BREAST LUMPECTOMY
BREAST LUMPECTOMY

AN OPERATION TO REMOVE LUMPS/TUMOURS OF THE BREAST.

COLECTOMY
COLECTOMY

AN OPERATION TO REMOVE PART OF/THE ENTIRE COLON.

COLONOSCOPY
COLONOSCOPY

AN ENDOSCOPIC EXAMINATION OF THE LARGE INTESTINE (COLON & RECTUM).

DISTAL PANCREATECTOMY
DISTAL PANCREATECTOMY

THE PANCREAS IS EXPOSED AND FREED FROM THE ADJACENT ORGANS. THE TAIL (DISTAL) HALF OF THE PANCREAS IS REMOVED. THE BLOOD VESSELS THAT GO TO THE SPLEEN PASS THROUGH THE PANCREAS. AS A RESULT THE SPLEEN ALSO SOMETIMES NEEDS TO BE REMOVED.

DRAINAGE PERI-ANAL ABSCESS
DRAINAGE PERI-ANAL ABSCESS

AN INCISION IN THE SKIN NEXT TO THE ANUS TO DRAIN PUS.

ERCP
ERCP

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY, INVOLVES PASSING A FLEXIBLE ENDOSCOPE (DUODENOSCOPE) THROUGH THE MOUTH AND STOMACH TO THE FIRST PART OF THE BOWEL CALLED THE DUODENUM.

FEMORAL HERNIA REPAIR (OPEN)
FEMORAL HERNIA REPAIR (OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN THE MUSCLES WHICH FORM THE LOWER FRONT OF THE STOMACH (IN THE GROIN REGION).

GASTRECTOMY
GASTRECTOMY

AN OPERATION THAT REMOVES EITHER PART OF THE STOMACH (PARTIAL) OR THE ENTIRE STOMACH (TOTAL).

GASTROSCOPY
GASTROSCOPY

AN ENDOSCOPIC EXAMINATION OF THE STOMACH.

HAEMORRHOIDECTOMY
HAEMORRHOIDECTOMY

AN OPERATION TO REMOVE COMPLICATED HAEMORRHOIDS (PILES).

INCISIONAL HERNIA REPAIR (LAPAROSCOPIC/OPEN)
INCISIONAL HERNIA REPAIR (LAPAROSCOPIC/OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN AN AREA WHERE PREVIOUS MUSCLE CLOSURE HAS BEEN PERFORMED (AFTER AN ABDOMINAL OPERATION).

INGUINAL HERNIA REPAIR (OPEN/LAPAROSCOPIC)
INGUINAL HERNIA REPAIR (OPEN/LAPAROSCOPIC)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN THE MUSCLES WHICH FORM THE LOWER FRONT OF THE STOMACH (IN THE GROIN REGION).

LAPAROSCOPIC CHOLECYSTECTOMY (GALL STONES)
LAPAROSCOPIC CHOLECYSTECTOMY (GALL STONES)

REMOVAL OF GALLBLADDER BY MEANS OF MINIMALLY INVASIVE “KEY-HOLE SURGERY”.

LIVER BIOPSY
LIVER BIOPSY

THE DOCTOR WILL TAKE A VERY SMALL PIECE OF YOUR LIVER (ABOUT 1/50,000TH OF YOUR LIVER) TO SEND FOR FURTHER TESTS.

LIVER RESECTION
LIVER RESECTION

THE SURGICAL REMOVAL OF PART OF THE LIVER.

MASTECTOMY
MASTECTOMY

AN OPERATION TO REMOVE THE ENTIRE BREAST

NEUROSTIMULATOR IMPLANT
NEUROSTIMULATOR IMPLANT

WITH INTERSTIM THERAPY, A SACRAL NEUROMODULATION DEVICE IS IMPLANTED DURING A MINIMALLY INVASIVE PROCEDURE.

NISSEN FUNDOPLICATION (LAPAROSCOPIC)
NISSEN FUNDOPLICATION (LAPAROSCOPIC)

AN OPERATION PERFORMED TO RELIEVE GASTRO-OESOPHAGEAL REFLUX; MOST OFTEN ASSOCIATED WITH A HIATUS HERNIA.

OESOPHAGEAL MANOMETRY
OESOPHAGEAL MANOMETRY

OESOPHAGEAL MANOMETRY IS A TEST THAT MEASURES THE FUNCTION AND MOVEMENT OF THE OESOPHAGUS AND THE CHARACTERISTICS OF THE VALVE BETWEEN THE OESOPHAGUS AND THE STOMACH.

PARATHYROIDECTOMY
PARATHYROIDECTOMY

AN OPERATION TO REMOVE PARATHYROID GLAND/S OR PARATHYROID TUMOURS.

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

A PEG IS A WAY OF INTRODUCING FOOD, FLUIDS AND MEDICINES DIRECTLY INTO THE STOMACH BY PASSING A THIN TUBE THROUGH THE SKIN AND INTO THE STOMACH.

PILONIDAL ABSCESS/SINUS EXCISION
PILONIDAL ABSCESS/SINUS EXCISION

AN ELLIPTICAL INCISION IS MADE REMOVING THE AFFECTED SKIN AND INVOLVED TISSUE OVER THE BUTTOCK CLEFT.

RECTAL PROLAPSE (ABDOMINAL REPAIR)
RECTAL PROLAPSE (ABDOMINAL REPAIR)

AN OPERATION PERFORMED TO REPAIR A RECTUM THAT PROLAPSES THROUGH THE ANUS.

RECTOCELE REPAIR
RECTOCELE REPAIR

AN OPERATION PERFORMED TO STRENGTHEN THE WALL OF THE VAGINA WHICH STOPS THE RECTUM FROM PROTRUDING INTO THE VAGINA.

SMALL BOWEL RESECTION
SMALL BOWEL RESECTION

SURGERY TO REMOVE A PART OF YOUR SMALL BOWEL.

SPLENECTOMY (LAPAROSCOPIC/OPEN)
SPLENECTOMY (LAPAROSCOPIC/OPEN)

AN OPERATION TO REMOVE THE SPLEEN.

STOMA CREATION/CLOSURE
STOMA CREATION/CLOSURE

A STOMA IS AN OPENING ANYWHERE ALONG THE LENGTH OF THE BOWEL TO THE EXTERIOR SKIN SURFACE TO CREATE AN ARTIFICIAL ANUS.

THYROIDECTOMY
THYROIDECTOMY

AN OPERATION TO REMOVE PART OF/THE ENTIRE THYROID GLAND.

TOTAL PANCREATECTOMY
TOTAL PANCREATECTOMY

REMOVING YOUR WHOLE PANCREAS, YOUR DUODENUM, A SMALL PORTION OF YOUR STOMACH, THE GALLBLADDER AND PART OF YOUR BILE DUCT, YOUR SPLEEN AND MANY OF THE SURROUNDING LYMPH NODES.

UMBILICAL HERNIA REPAIR (OPEN)
UMBILICAL HERNIA REPAIR (OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS/SWELLING OF THE NAVEL (BELLY BUTTON).

WHIPPLE’S (PANCREATICODUODENECTOMY)
WHIPPLE’S (PANCREATICODUODENECTOMY)

THIS IS A MAJOR OPERATION TO REMOVE THE HEAD OF THE PANCREAS.