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What Is Distal Pancreatectomy?

Distal pancreatectomy is surgery that removes the body and tail of the pancreas while leaving the pancreatic head in place. The operation is used for selected benign, premalignant, and malignant tumors located in the left side of the pancreas. The spleen is commonly removed with the pancreas during cancer surgery but can be preserved in selected benign or low-grade conditions. The procedure can be performed through an open, laparoscopic, or robotic approach.

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What Is Distal Pancreatectomy?

Distal pancreatectomy is surgery that removes the body and tail of the pancreas while leaving the pancreatic head in place. The operation is used for selected benign, premalignant, and malignant tumors located in the left side of the pancreas. The spleen is commonly removed with the pancreas during cancer surgery but can be preserved in selected benign or low-grade conditions. The procedure can be performed through an open, laparoscopic, or robotic approach.

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Why Is Distal Pancreatectomy Performed?

The operation is used for pancreatic tumors, cystic neoplasms, neuroendocrine tumors, selected cancers, chronic pancreatitis, and some traumatic injuries involving the body or tail. The treatment plan depends on the diagnosis, tumor location, relationship to the splenic vessels, suspected malignancy, and overall pancreatic function. Spleen preservation can be considered when oncologic lymph-node clearance is not required and the splenic blood supply can be maintained. Suspected pancreatic cancer generally requires removal of regional lymphatic tissue and often the spleen.

How Is Distal Pancreatectomy Performed?

The surgeon exposes the body and tail of the pancreas and separates the planned resection from nearby stomach, colon, kidney, adrenal gland, and major vessels. The pancreas is divided with a stapler, sutures, energy device, or another closure technique, and the distal specimen is removed. The splenic artery and vein are divided when the spleen is removed, while spleen-preserving techniques either preserve these vessels or rely on short gastric and gastroepiploic collateral circulation. A drain can be placed near the pancreatic stump depending on operative findings and surgeon practice.

What Is Recovery Like After Distal Pancreatectomy?

Patients are monitored for pancreatic fistula, bleeding, infection, fluid collections, blood-glucose changes, pain, and return of gastrointestinal function. Eating and walking are advanced as recovery progresses, and drains are managed according to output and pancreatic-enzyme measurements when present. Removal of enough pancreatic tissue can reduce insulin or digestive-enzyme production and can lead to diabetes or exocrine pancreatic insufficiency. Patients who undergo splenectomy also need appropriate vaccination and education about infection risk.

What Are the Risks and Complications?

Postoperative pancreatic fistula is one of the most common complications after distal pancreatectomy and occurs when pancreatic fluid leaks from the cut pancreatic remnant. Other risks include bleeding, infection, intra-abdominal abscess, delayed gastric emptying, blood clots, and injury to nearby organs. Splenectomy adds risks related to overwhelming infection and can also affect blood-cell and clotting patterns. Long-term complications can include diabetes, pancreatic enzyme insufficiency, weight loss, or recurrent disease depending on the amount of pancreas removed and the underlying diagnosis.

Frequently Asked Questions About Distal Pancreatectomy

Which part of the pancreas is removed during distal pancreatectomy?

The operation removes the pancreatic body and tail. The pancreatic head and its connection to the duodenum remain in place.

Is the spleen always removed during distal pancreatectomy?

No. Spleen preservation is possible in selected benign or low-grade conditions, while cancer surgery often includes splenectomy for adequate oncologic resection.

What is the main complication after distal pancreatectomy?

Postoperative pancreatic fistula is a major complication and results from leakage of pancreatic fluid from the cut surface of the remaining pancreas.

Can distal pancreatectomy cause diabetes?

Yes. Removing pancreatic tissue reduces insulin-producing capacity, so new or worsened diabetes can develop, particularly when a large amount of pancreas is removed.

References

Distal Pancreatectomy. StatPearls (NCBI Bookshelf). https://www.ncbi.nlm.nih.gov/books/NBK564309/. Date Accessed August 13, 2026.

About Your Distal Pancreatectomy. Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/patient-education/about-your-distal-pancreatectomy. Date Accessed August 13, 2026.

A Review of Post-Operative Pancreatic Fistula Following Distal Pancreatectomy. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC12427430/. Date Accessed August 13, 2026.

Kimura's vs Warshaw's technique for spleen preserving distal pancreatectomy: a systematic review and meta-analysis of high-quality studies. PubMed. https://pubmed.ncbi.nlm.nih.gov/36941150/. Date Accessed August 13, 2026.

Impact of spleen preservation on the incidence of clinically relevant postoperative pancreatic fistula after distal pancreatectomy. PubMed. https://pubmed.ncbi.nlm.nih.gov/35945100/. Date Accessed August 13, 2026.