Can You Live Without a Pancreas?

The organs in your body serve a purpose, so it’s perplexing that you can live without some of them. 

You can live without a gallbladder, spleen, and one of your kidneys, but what about your pancreas?

Your pancreas is an important organ that poses great challenges to live without, but it is possible. 

What does the pancreas do?

The pancreas is an organ located behind your stomach. The pancreas secretes digestive enzymes, which help break down food when it enters your intestines. Enzymes produced in the pancreas include trypsin and chymotrypsin (helps digest protein), amylase (breaks down carbohydrates), and lipase (breaks down fats).

Your pancreas contains beta cells that produce insulin. Insulin is important to help allow blood glucose (sugar) into your cells. Cells need this glucose for energy since glucose is your body’s preferred method of fuel.

Cells have insulin receptors, and insulin attaches to them to allow glucose to get into your cells. An easier way to think of it is that the cells have doors, the insulin receptors are the locks on the door of the cells, and insulin is the key to opening the door to allow sugar in.

Without enough insulin, blood sugar builds up in the bloodstream as it cannot enter the cells to provide energy. When this is the case, diabetes occurs.

Your pancreas also contains cells that make glucagon, a hormone that stimulates your body to release stored sugar to help prevent low blood sugar. Both insulin and glucagon are important to keep your blood sugars from going very high and very low.

Can you live without a pancreas?

You can live without a pancreas, but it requires many adjustments to your healthcare and lifestyle routines. Without a pancreas, you’d need to inject insulin to manage your blood sugars because your body would no longer produce any insulin.

Living without a pancreas also means you need to take digestive enzymes to help you digest your food. Without enough pancreatic enzymes, you can develop malabsorption, which is when your body cannot absorb all of the nutrients from food.

Some signs of pancreatic enzyme insufficiency include:

• Abdominal pain, gas, and bloating
• Constipation
• Diarrhea
• Fatty stools/steatorrhea (pale, oily, foul-smelling poop that floats)
• Unexplained weight loss or failure to thrive in infants and children

What is a pancreatectomy?

A pancreatectomy is the surgical removal of the pancreas. There are different surgical methods of removing the pancreas, depending on whether there are malignant (cancerous) parts of the pancreas or benign (non-cancerous) parts of the pancreas (1).

A total pancreatectomy involves the removal of the entire pancreas, as well as the gallbladder and common bile duct, portions of the small intestine and stomach, and most often the spleen.

In some cases, a Whipple procedure may be done, which is when the head of the pancreas is removed, along with the gallbladder. This procedure is beneficial if a tumor is located on the head of the pancreas, so the whole pancreas doesn’t have to be removed. Similarly, a distal pancreatectomy is when the tail end of the pancreas is removed.

After a total pancreatectomy, there may be an autologous (auto-) islet transplantation. Islet cells are a type of cell that produces hormones like insulin; beta cells are a type of islet cell.

An auto-islet transplantation can be used to treat chronic pancreatitis, a painful inflammation of the pancreas that can damage the organ. After the removal of the pancreas, the surgeon removes the islet cells from the removed pancreas and transplants them into the patient via the liver. 

Auto-islet transplantations help the patient to make their insulin after their pancreatectomy. Auto-islet cell transplantation isn’t suitable for people with existing diabetes because they usually don’t have enough functioning islet cells to begin with, especially in the case of type 1 diabetes.

What are the side effects of pancreatic surgery?

There are several potential side effects of having pancreatic surgery. Some of the risks from surgery include postoperative pain, bleeding, infection, blood clots, bile leakage, and digestive issues.

If you have a total pancreatectomy, you’ll need to take insulin to manage your blood sugar levels. Removing your entire pancreas means you’ll have diabetes afterward. However, removing part of your pancreas might not result in diabetes.

If you’ve only had part of your pancreas removed, watch out for some signs of diabetes, including:

• Increased thirst
• Increased urination
• Unintentional weight loss
• Fatigue
• Increased hunger
• Slow wound healing
• Vision changes

How long is recovery from pancreas removal?

Recovery from a total pancreatectomy will vary depending on your age, health status, and other factors. Generally, you can expect to take about one month off from work. It will take around three months for you to regain your strength and start feeling a little closer to normal.

If you had a pancreatectomy due to cancer, you might still need to undergo chemotherapy or radiation to remove any cancer that is still in your body, which would prolong recovery.

Why would someone have their pancreas removed?

Several health conditions could warrant a total pancreatectomy. Some of the most common reasons include:

• Acinar cell tumors
• Adenocarcinoma (85% of all cancers in the pancreas)
• Cancer of the ampulla of Vater (ampullary cancer)
• Cancer of the distal (lower portion) of the bile duct
• Cystadenocarcinoma
• Cystadenoma 
• Duodenal cancer
• Inflammation
• Islet cell tumors (neuroendocrine tumors)
• Lymphoma
• Necrotizing pancreatitis
• Neoplasms
• Papillary cystic neoplasms
• Severe chronic pancreatitis
• Severe hyperinsulinemic hypoglycemia
• Severe trauma

What can I expect after my pancreas is removed?

After your pancreas is removed, you’ll need to take pancreatic enzymes with all of your meals. You might still have nutrient malabsorption, which can lead to fatty stools and nutrient deficiencies. You should do routine blood work after surgery to identify any potential nutrient deficiencies.

You’ll likely need to adjust your diet after your pancreas is removed. Aim to have small meals throughout the day instead of large meals, which may be harder to digest without enough pancreatic enzymes.

You’ll need to inject insulin several times a day when your entire pancreas is removed. Mealtime (short-acting) insulin is taken before meals, and basal (long-acting) insulin is usually taken twice a day.  There are other insulin regimens to fit your lifestyle, blood sugar trends, and other factors.

How long can a person live without a pancreas?

The reason for removing the pancreas will determine how long a person will live without a pancreas. Patients with pancreatic adenocarcinoma (the main type of pancreatic cancer) have a shorter life expectancy even after pancreatic removal. 

According to a study, about 34% of patients with pancreatic adenocarcinoma were alive three years after the surgery, whereas 65% of the people in the entire study group were alive three years post-surgery (2).

Diabetes after pancreas removal

If you have a total pancreatectomy, you will have diabetes afterward. Without a pancreas, your body can’t make any insulin, which is required to control your blood sugar levels. 

If you only have part of your pancreas removed, you might not have diabetes immediately after your surgery depending on how much of your pancreas was removed. 

Your healthcare provider will routinely monitor your blood sugar levels to assess how severe your diabetes is after a total pancreatectomy. 

Coping and lifestyle tips

Meet with a diabetes educator

You’ll probably feel overwhelmed after your total pancreatectomy. Not only do you have to adjust to an altered digestive system, but you also have a new diagnosis of diabetes to learn to manage.

A Certified Diabetes Care & Education Specialist (CDCES; formerly CDE) is knowledgeable about many aspects of diabetes, including medication management, diet, and other resources that can help you.

Ask your primary care provider for a referral to a CDCES to help you navigate your new lifestyle. In addition, they’ll likely refer you to an endocrinologist, a specialist who works with patients with complex conditions like type 1 diabetes and diabetes from a total pancreatectomy.

Check your blood sugar often

Checking your blood sugar several times a day can help you better learn your new blood sugar trends. Checking blood sugar levels regularly helps improve your blood sugar control and reduce the likelihood of complications from diabetes.

Check your blood sugar when you feel dizzy, hungry, or start sweating, which are signs of low blood sugar. Keep hard candy on hand to treat blood sugar levels below 70 mg/dL, which are considered low. 

Focus on healthy carbohydrates, not getting rid of all carbohydrates

Carbohydrates (carbs) are in fruit, vegetables, grains, legumes, and dairy products like milk and yogurt. They’re also in sugar-sweetened products like desserts and sugary drinks.

Carbohydrates aren’t bad, but they have the biggest impact on your blood sugar level compared to other nutrients like protein and fat. When you eat carbohydrates, they’re broken down into glucose in your bloodstream.

Not all carbohydrates are created equally. Carbs from fruits, vegetables, whole grains, legumes, and unsweetened dairy products are much better for you than refined carbs like sugar-sweetened foods and drinks and grains made from enriched flour.

Instead of looking to cut out carbs or go on a very low carbohydrate diet for a new diabetes diagnosis after a pancreatectomy, try to improve the quality of the carbs in your diet. 

Aim to keep your added sugar intake below 40 grams per day to help you better manage your blood sugar levels.

Avoid eating fried foods

Eating a lot of fatty foods can cause fat malabsorption when you don’t have enough pancreatic enzymes. In addition, a total pancreatectomy removes your gallbladder, which helps release large doses of bile to help break down fats in your diet.

Taking prescription pancreatic enzymes with meals is beneficial, but it’s not the same as your body naturally producing enough enzymes and releasing bile based on the foods you eat.

Instead of fried and greasy food, try to choose those that are baked, steamed, boiled, broiled, or cooked in an air fryer, which helps maintain the crisp texture of foods without the added fat.

Conclusion

It is possible to live without a pancreas, but it takes intensive medical management and lifestyle changes. The main ways a total pancreatectomy will impact you are the loss of insulin/new diabetes and the absence of digestive enzymes. However, thanks to advances in the medical field, there is hope that you can live a happy life for years after a pancreatectomy.

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