After a pancreatoduodenectomy, what will happen of the functions these organs served?
The pancreas serves two main functions. The exocrine portion of the gland secrete digestive juices, while the endocrine portion secretes hormones, the most important being insulin. The lack of insulin is the cause for Diabetes mellitus. However, since only the head of the pancreas is removed, the remaining portion of the pancreas will generally take care of these functions .
The duodenum mainly acts as a passage for food from the stomach to the rest of the intestines. This will be taken care of by the new connections(anastamoses) which will be created using the small intestine.
I find my stools to be foul-smelling and bulky. Is it normal?
This is called steatorrhoea, caused by incomplete digestion as a result of inadequate pancreatic digestive juices. This may be associated with a sense of abdominal fullness and weight loss too. This is uncommon following pancreatoduodenectomy and is common after total pancreatectomy. However, if the remaining pancreas was also not functioning well due to other diseases like pancreatitis, which may have been present even prior to development of cancer, steatorrhoea may occur.
Treatment: Pancreatic enzyme supplements (Cap. Creon 10000 to 25000 units along with meals) life long.
How would I know if I have developed Diabetes following pancreatoduodenectomy?
During your follow up visits, blood tests will be performed, which will be able to identify diabetes. In addition, if you develop symptoms like excessive urination, excessive appetite, excessive thirst, or a wound that does not heal, please do test for blood sugar levels.
Of late I have been losing weight. What is it likely due to?
If weight loss is associated with bulky, foul smelling stools, it may be due to pancreatic enzyme insufficiency. This should improve after adding pancreatic enzyme supplements. Otherwise, it may be due to recurrence of disease, which will need to be evaluated with blood tests like CA 19-9 and Ultrasonography or CT scans. Please contact your doctor at MICC or schedule an early appointment.
Why do I experience burning sensation/pain in the upper abdomen?
This is likely due to entry of bile, a digestive juice, into the stomach, causing irritation and pain. You might also develop vomiting of yellow-green liquid.
Treatment: Use of antimotility drugs like Tab. Domperidone 10 mg thrice a day may help.
When can I start working again?
It is advisable to avoid lifting weights for a period of about 3 months after surgery, to enable the scar to gain strength. If your work does not involve strenuous physical activity, you may resume working as soon as you feel fit. A healthy, active lifestyle is encouraged. If your lifestyle is otherwise sedentary, physical activities like brisk walking, etc. are suggested, at least thrice a week.
Can I resume sexual activities as prior to my illness?
Yes, you can resume sexual activities. However, if you have received Chemotherapy, please talk to the medical oncologist before you plan to have children.