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Total pancreatectomy

Michael D Kluger, MD, MPH
James Lee, MD
John Chabot, MD
Section Editors
Sally E Carty, MD, FACS
Stanley W Ashley, MD
Deputy Editor
Wenliang Chen, MD, PhD


The pancreas has exocrine and endocrine functions that are essential to life. A loss of such functions can result from either disease (eg, chronic pancreatitis, cystic fibrosis) or surgery (total pancreatectomy). The development of long-acting insulin and effective digestive enzymes have made it possible for patients to sustain a reasonable quality of life after a total pancreatectomy.

Total pancreatectomy has been performed since the 1970s, and its frequency has increased over the last two decades. The anatomy of the pancreas makes it difficult to remove. Along its length, the pancreas contacts almost all structures of the upper abdomen, and the head of the pancreas is densely adherent to the duodenum and envelops the distal common bile duct. As a result, a total pancreatectomy most often requires a concomitant duodenectomy, and subsequent gastric and biliary anastomoses to the jejunum to preserve gastrointestinal continuity.

The indications for and techniques of total pancreatectomy are discussed in this topic. Techniques of partial pancreatic resection are discussed in other topics. (See "Surgical resection of lesions of the head of the pancreas" and "Surgical resection of lesions of the body and tail of the pancreas".)


Total pancreatectomy is a major operation with potential for mortality and severe morbidity. It is reserved for patients who have failed medical management and are not candidates for less extensive surgery. The indications for total pancreatectomy:

Severe benign or intractable conditions that cannot be effectively treated medically or with less extensive resection:

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Literature review current through: Nov 2017. | This topic last updated: Oct 09, 2017.
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