Spleen and Partial Pancreas Removal: Pre-Op Vaccination and Care Guide

Regarding total splenectomy and partial pancreatic resection (30-40%) surgical issues?

I am a 24-year-old male, non-smoker and non-drinker.
My father has a history of diabetes.
In October, I was diagnosed with a large cyst (approximately 13x10 cm) located between my spleen and pancreas, pressing down on my left kidney.
After examination, the doctor determined that I need to undergo a major surgery to remove my entire spleen and part of my pancreas (30-40%).
Currently, I am experiencing mild abdominal distension and discomfort on the left side, but otherwise feel normal.
I have the following questions:
1.
If I undergo surgery, should I receive vaccinations before the procedure or after?
2.
What specific vaccines are required?
3.
If vaccinations are needed before surgery, how long in advance should they be administered? If they are to be given after surgery, when should that occur?
Are there any other important considerations I should be aware of? Thank you for your response.

Niming, 20~29 year old female. Ask Date: 2019/11/28

Dr. Chen Jiaming reply Surgery

1.
For emergency splenectomy, it is recommended to administer vaccinations two weeks post-surgery; for elective surgeries (scheduled), it is advised to administer vaccinations two weeks prior to the procedure.

2.
The following individual vaccines are recommended:
(a) Streptococcus pneumoniae (pneumococcal vaccine)
(b) Haemophilus influenzae type B (Hib vaccine)
(c) Neisseria meningitidis (meningococcal vaccine)
3.
For patients scheduled to undergo elective splenectomy, it is recommended to receive the pneumococcal vaccine injection 10 to 14 days prior to surgery (± Hib vaccine and meningococcal vaccine) to reduce the incidence of post-operative sepsis (80% within the first two years post-surgery).

Reply Date: 2019/11/28

More Info

When preparing for a surgical procedure such as a splenectomy (removal of the spleen) and partial pancreatectomy (removal of part of the pancreas), there are several important considerations regarding vaccinations and overall pre-operative care. Given your medical history and the nature of your surgery, here’s a comprehensive guide to help you navigate this process.

1. Pre-Operative Vaccination
It is highly recommended that you receive certain vaccinations before undergoing surgery. The spleen plays a crucial role in the immune system, particularly in fighting infections. After a splenectomy, patients are at a higher risk for infections, especially from encapsulated bacteria. Therefore, vaccination is an essential step in reducing this risk.

2. Recommended Vaccines
The following vaccines are typically recommended for patients undergoing splenectomy:
- Pneumococcal Vaccine (Streptococcus pneumoniae): This vaccine protects against pneumonia and other serious infections caused by pneumococcal bacteria.

- Haemophilus influenzae type b (Hib) Vaccine: This vaccine protects against infections caused by Hib, which can lead to severe illnesses like meningitis.

- Meningococcal Vaccine (Neisseria meningitidis): This vaccine protects against meningitis and other serious infections caused by meningococcal bacteria.

3. Timing of Vaccination
- Pre-Operative Vaccination: If your surgery is planned (not an emergency), it is advisable to receive these vaccinations 10 to 14 days prior to the surgery. This timeframe allows your body to build an adequate immune response to the vaccines.

- Post-Operative Vaccination: If you are unable to receive the vaccines before surgery, it is generally recommended to get vaccinated at least two weeks after the surgery. This delay allows your body to recover from the surgical procedure before introducing the vaccines.

4. Additional Pre-Operative Considerations
- Medical Evaluation: Ensure that you have a thorough pre-operative assessment by your healthcare provider. This should include a review of your medical history, current medications, and any potential allergies.

- Blood Tests: You may need to undergo blood tests to check your overall health and ensure that your blood counts are adequate for surgery.

- Dietary Restrictions: Follow any dietary restrictions provided by your surgical team, especially as the surgery date approaches.

- Medication Management: Discuss with your physician any medications you are currently taking, including those for diabetes, as your father has a history of this condition. Adjustments may be necessary based on your surgery and recovery.

- Post-Operative Care: Be prepared for post-operative care, which may include pain management, monitoring for signs of infection, and follow-up appointments to assess your recovery.

Conclusion
In summary, it is crucial to receive vaccinations before undergoing a splenectomy and partial pancreatectomy to mitigate the risk of infections post-surgery. Aim to get vaccinated 10 to 14 days before your procedure, and if that is not possible, plan to receive them two weeks after the surgery. Always maintain open communication with your healthcare team regarding your health status and any concerns you may have leading up to your surgery. This proactive approach will help ensure a smoother surgical experience and recovery.

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