OPERATION: Distal Pancreatectomy and Splenectomy (Open)
ANAESTHETIC: General anaesthesia with epidural
ANTIBIOTICS: IV cephalosporin at induction
PRE-OPERATIVE VACCINATIONS: Pneumococcal, Haemophilus influenzae type b, and meningococcal vaccines administered ≥2 weeks pre-operatively (elective cases).
POSITION: Supine. Nasogastric tube and urinary catheter. VTE prophylaxis.
INDICATION:
[Pancreatic body/tail neoplasm / symptomatic chronic pancreatitis limited to body and tail / chronic pancreatic fistula or pseudocyst from distal pancreas]. Preoperative imaging: CT/MRI [findings, relationship to SMV/portal confluence]. [EUS / staging CT for malignancy].
PROCEDURE:
WHO Checklist performed. Bilateral subcostal [/ midline] incision.