48120 Excision of lesion of pancreas (eg, cyst, adenoma)

Name of the Procedure:

Excision of Lesion of Pancreas (e.g., Cyst, Adenoma)

Summary

In layman's terms, an excision of a lesion of the pancreas is a surgical procedure to remove abnormal growths, such as cysts or adenomas, from the pancreas. This is done to prevent complications or to treat symptoms caused by these growths.

Purpose

This procedure addresses conditions such as pancreatic cysts, adenomas, or other benign pancreatic lesions. The goal is to remove the abnormal tissue to alleviate symptoms, prevent potential complications, such as rupture or infection, and to obtain a definitive diagnosis through pathological examination of the excised tissue.

Indications

Indications for this procedure include:

• Presence of symptomatic pancreatic cysts or adenomas.
• Imaging studies showing suspicious or potentially pre-cancerous pancreatic lesions.
• Growth or changes in pancreatic lesions over time.
• Symptoms such as abdominal pain, nausea, vomiting, or jaundice that are directly linked to pancreatic lesions.

Preparation

Pre-procedure instructions for the patient may include:

• Fasting for a specific period before the procedure to ensure an empty stomach.
• Adjusting or stopping certain medications, particularly blood thinners.
• Undergoing diagnostic tests such as blood tests, abdominal MRI or CT scans, and possibly an endoscopic ultrasound (EUS) to evaluate the lesion.

Procedure Description

1. The patient is brought to the operating room and placed under general anesthesia.
2. The surgeon makes an incision in the abdomen to access the pancreas.
3. Using specialized surgical tools, the surgeon carefully excises the lesion from the pancreas.
4. The excised lesion is sent for pathological examination.
5. The surgeon closes the incision with sutures or staples.

Tools and equipment used may include surgical scalpels, retractors, forceps, and sometimes a laparoscope for minimally invasive cases.

Duration

The procedure typically takes 2 to 4 hours, depending on the size and location of the lesion and whether a minimally invasive approach is used.

Setting

The excision of a pancreatic lesion is usually performed in a hospital operating room.

Personnel

The procedure involves:

• A surgeon specialized in pancreatic surgery
• An anesthesiologist to administer and monitor anesthesia
• Surgical nurses and technicians to assist with the procedure

Risks and Complications

Common risks include:

• Infection
• Bleeding
• Pancreatic fistula (leakage of pancreatic fluid)
• Delayed gastric emptying

Rare risks include:

• Damage to surrounding organs
• Blood clots
• Adverse reactions to anesthesia

Complications are managed through medical intervention, additional surgery, or specific treatments depending on the nature of the issue.

Benefits

The main benefits of this procedure include relief from symptoms, prevention of complications such as infection or rupture, and obtaining an accurate diagnosis. These benefits generally become apparent within a few weeks following surgery.

Recovery

Post-procedure care includes:

• Hospital stay for several days to monitor for complications.
• Pain management with prescribed medications.
• Gradual reintroduction to normal diet and activity levels.
• Follow-up appointments for monitoring healing and to discuss pathology results.

Expected recovery time is typically 4 to 6 weeks, during which heavy lifting and strenuous activities should be avoided.

Alternatives

Alternatives to this procedure include:

• Monitoring the lesion with regular imaging and check-ups (for asymptomatic or stable lesions).
• Endoscopic drainage or aspiration (for certain types of cysts).
• Medications to manage symptoms.

The pros and cons of alternatives should be discussed with a healthcare provider to determine the best approach based on the individual patient's condition and overall health.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, there may be pain and discomfort at the incision site, which is managed with pain relief medications. Patients will experience progressive improvement and return to normal activities over the recovery period, with close monitoring by their healthcare team to ensure a smooth recovery.