Question 1

Is this a very risky operation?

Accepted Answer

It's a major, complex operation, but outcomes have improved significantly at experienced centers — your team will discuss your individual risk.

Question 2

Will I become diabetic?

Accepted Answer

Some patients develop or worsen diabetes since part of the pancreas is removed; this is monitored closely and managed if it occurs.

Question 3

Will I need enzyme tablets for digestion?

Accepted Answer

Many patients need pancreatic enzyme supplements with meals afterward to help digest food properly.

Question 4

Will I need my spleen removed too?

Accepted Answer

In most distal pancreatectomies yes, because the two organs share blood vessels; spleen-preserving techniques are used when safely possible.

Question 5

What precautions are needed without a spleen?

Accepted Answer

Specific vaccinations (against pneumococcus and other bacteria) and prompt medical attention for fevers are recommended long-term.

Question 6

Will this cure my chronic pancreatitis?

Accepted Answer

It relieves the pain caused by duct obstruction, but chronic pancreatitis is a long-term condition requiring ongoing lifestyle and medical management.

Question 7

Will I still need enzyme or insulin treatment?

Accepted Answer

If the pancreas is already significantly damaged from long-standing pancreatitis, these may still be needed regardless of surgery.

Question 8

Why wait 6 weeks before treating a pseudocyst?

Accepted Answer

This allows the cyst wall to mature and thicken, making a safe, durable connection to the stomach possible.

Question 9

Can the cyst come back?

Accepted Answer

Recurrence is uncommon once properly drained, though it can happen if the underlying pancreatic duct injury isn't addressed.

Question 10

Is this a replacement for open surgery?

Accepted Answer

It's used as a less invasive first-line approach for infected necrosis, reserving open surgery for cases that don't respond.

Question 11

Will I need more than one procedure?

Accepted Answer

Some patients need repeat sessions through the same small tract to fully clear the infected tissue.

Question 12

Will my liver grow back?

Accepted Answer

Yes, the liver has a remarkable capacity to regenerate, often returning to near-normal size within a couple of months.

Question 13

How much liver can safely be removed?

Accepted Answer

This depends on the health of your remaining liver, assessed carefully before surgery with imaging and blood tests — often up to 70-80% can be safely removed in a healthy liver.

Question 14

Is this as effective as surgery?

Accepted Answer

For well-selected, uncomplicated cysts, PAIR has success rates comparable to surgery with a much smaller recovery burden.

Question 15

Will I need medication too?

Accepted Answer

Yes, anti-parasitic medication is typically given before and after the procedure to reduce recurrence risk.

Question 16

Will the cyst come back?

Accepted Answer

Recurrence is uncommon once adequately deroofed, though rare regrowth can occur and would be monitored.

Question 17

How is this different from draining the cyst with a needle?

Accepted Answer

Needle aspiration alone almost always allows the cyst to refill; deroofing removes the wall so fluid can permanently escape into the abdomen instead.

Question 18

Can I live without a gallbladder?

Accepted Answer

Yes, the liver continues to produce bile which flows directly into the intestine; most people notice no significant difference in digestion.

Question 19

How soon can I go back to work?

Accepted Answer

Most people return to desk work within a week and to more physical jobs within 2 weeks.

Question 20

Why not just remove the stones with an endoscope?

Accepted Answer

This is always tried first; surgery is used when stones are too large, numerous, or inaccessible for endoscopic (ERCP) clearance.

Question 21

Will I need this reconstruction long-term?

Accepted Answer

The new connection (hepaticojejunostomy) is a permanent, durable solution designed to function for life.

Question 22

Why is more than the gallbladder removed?

Accepted Answer

Gallbladder cancer can spread early into the adjacent liver and lymph nodes, so a wider clearance improves the chance of complete cure.

Question 23

Is this found before or after gallbladder removal?

Accepted Answer

Both — sometimes cancer is suspected beforehand on imaging, and sometimes it's an unexpected finding after a routine gallbladder removal, requiring a second, more extensive operation.

Question 24

Can I live normally without a spleen?

Accepted Answer

Yes, most people live a full, active life without a spleen, though some precautions around infection risk are needed long-term.

Question 25

Will I need vaccinations?

Accepted Answer

Yes, vaccines against specific bacteria are recommended, ideally a couple of weeks before a planned splenectomy or soon after an emergency one.

Question 26

Is this always done laparoscopically?

Accepted Answer

Most planned splenectomies are done laparoscopically; very large spleens or emergency trauma surgery sometimes require an open approach.

Question 27

Who is this surgery suitable for?

Accepted Answer

It's best suited to patients with portal hypertension from non-cirrhotic causes or blocked portal veins, with recurrent bleeding despite endoscopic treatment — careful case selection matters.

Question 28

Will the spleen always be removed too?

Accepted Answer

Yes, in a proximal splenorenal shunt, splenectomy is performed as part of creating the shunt connection.

Question 29

Can the shunt block over time?

Accepted Answer

It's uncommon but possible; regular follow-up imaging monitors that the shunt stays open.

HPB (Hepato-Pancreato-Biliary) Surgery

By Organ & Specific Surgery

Have Questions About This Procedure?

HPB (Hepato-Pancreato-Biliary) Surgery

By Organ & Specific Surgery

Have Questions About This Procedure?