PANCREATIC ONCOLOGY · CONDITION GUIDE

Pancreatic Neoplasm

Q: What is the difference between Whipple’s procedure and distal pancreatectomy?

Whipple’s procedure removes the head of the pancreas, duodenum, common bile duct, and gallbladder — used for tumours in the pancreatic head or periampullary region. Distal pancreatectomy removes the body and tail of the pancreas, usually with the spleen, for tumours in the left side of the pancreas. The appropriate operation is determined by tumour location.

Q: What are the chances of curing pancreatic cancer with surgery?

Only 15–20% of pancreatic adenocarcinomas are resectable at diagnosis due to late presentation. Among resected patients, 5-year survival is approximately 20–25% with surgery combined with adjuvant chemotherapy — significantly better than non-resected disease. For early-stage tumours detected incidentally, outcomes are considerably better.

Q: What is a pancreatic neuroendocrine tumour (PNET)?

A pancreatic neuroendocrine tumour arises from the hormone-producing islet cells of the pancreas. PNETs are generally less aggressive than adenocarcinoma and grow more slowly. They may be functional (producing excess hormones causing clinical syndromes) or non-functional. Small low-grade PNETs are treated by enucleation; larger or higher-grade tumours require formal resection.

Tumours of the pancreas — ranging from resectable adenocarcinoma to benign endocrine tumours — requiring precise surgical resection as part of a multidisciplinary oncological treatment plan.

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Pancreatic Neoplasms treatment by Dr. Tagore

Pancreatic LOCATION

2–6 Hours PROCEDURE DURATION

7–10 Days HOSPITAL STAY

ABOUT THIS CONDITION

What is Pancreatic Neoplasm?

Pancreatic neoplasms encompass a wide spectrum of tumours — pancreatic ductal adenocarcinoma (the most common and aggressive), pancreatic neuroendocrine tumours (PNETs), intraductal papillary mucinous neoplasms (IPMNs), mucinous cystadenomas, and solid pseudopapillary tumours. Surgical resection offers the only chance of cure for resectable malignancies and is indicated for symptomatic or high-risk benign tumours. Dr. Tagore Mohan Grandhi performs pancreatic resection at Lux Hospitals, Hyderabad, as part of a multidisciplinary hepatopancreaticobiliary (HPB) team. The operation — Whipple’s procedure, distal pancreatectomy, or tumour enucleation — is determined by tumour location, histological type, and proximity to the main pancreatic duct and vascular structures.

SIGNS TO WATCH

Common Symptoms

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Symptoms that need attention

Painless progressive jaundice in pancreatic head tumours obstructing the bile duct New-onset diabetes mellitus or worsening glycaemic control Epigastric pain radiating to the back in locally advanced disease Unexplained weight loss, anorexia, and fatigue Steatorrhoea from exocrine obstruction by the tumour Incidental finding of a pancreatic mass on imaging performed for other reasons

WHY IT HAPPENS

Causes & Risk Factors

Pancreatic ductal adenocarcinoma — associated with smoking, diabetes, and chronic pancreatitis
KRAS, CDKN2A, SMAD4, and TP53 gene mutations in adenocarcinoma
Hereditary syndromes — BRCA2, Lynch syndrome, Peutz-Jeghers increasing lifetime risk
Familial pancreatic cancer in first-degree relatives
Pancreatic neuroendocrine tumours from islet cell dysplasia — often sporadic
IPMN progression from mucinous ductal neoplasm to invasive carcinoma

CLINICAL DETAILS

KeyFacts

Pancreatic Head

Whipple’s procedure (pancreaticoduodenectomy)

Body / Tail

Distal pancreatectomy with or without splenectomy

Small Benign Tumours

Enucleation to preserve pancreatic parenchyma

Resectability

CT and MRI assess vascular involvement before surgery

5-Year Survival

Up to 20–25% for resected pancreatic adenocarcinoma

Hospital

Available at Lux Hospitals, Hitech City, Hyderabad

HOW WE TREAT IT

Treatment Approach

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Multidisciplinary HPB Team

Pancreatic neoplasms require meticulous pre-operative staging, expert surgical technique, and structured post-operative oncological follow-up. Dr. Grandhi works within a dedicated HPB multidisciplinary team including hepatology, oncology, interventional radiology, and nutrition to optimise outcomes at every stage of the treatment pathway.

Available at Lux Hospitals, Hitech City, Hyderabad

1

Staging & Resectability Assessment

High-quality pancreatic protocol CT and MRI assess tumour size, vascular involvement, lymph nodes, and distant metastases. EUS with biopsy provides tissue diagnosis. Staging laparoscopy excludes peritoneal disease.
2

MDT Planning & Neoadjuvant Therapy

The MDT determines resectability and the role of neoadjuvant chemotherapy for borderline resectable or locally advanced tumours. PNETs and cystic neoplasms are planned for direct resection.
3

Surgical Resection

Whipple’s procedure for head tumours; distal pancreatectomy for body/tail tumours; enucleation for small benign lesions. Vascular reconstruction is performed where superior mesenteric or portal vein involvement necessitates resection.
4

Post-operative Recovery & Oncology

PERT supplementation commenced. Adjuvant chemotherapy planned by MDT. Surveillance imaging at regular intervals. Dietetic support and diabetic management maintained throughout.

AVAILABLE TREATMENTS

TreatmentOptions

Whipple’s Procedure (Pancreaticoduodenectomy)

Resection of the pancreatic head, duodenum, bile duct, and gallbladder with reconstruction. Standard procedure for tumours of the pancreatic head and periampullary region.

Distal Pancreatectomy

Resection of the pancreatic body and tail, usually with splenectomy. Performed for tumours of the body and tail of the pancreas.

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COMMON QUESTIONS

Frequently Asked Questions

What is the difference between Whipple’s procedure and distal pancreatectomy?+

What are the chances of curing pancreatic cancer with surgery?+

What is a pancreatic neuroendocrine tumour (PNET)?+

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