Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Pancreatectomy


Related Terms

  • Distal Pancreatectomy
  • Excision of Pancreas
  • Partial Pancreatectomy
  • Total Pancreatectomy
  • Whipple Procedure

Specialists

  • Gastroenterologist
  • General Surgeon

Comorbid Conditions

Factors Influencing Duration

Factors that may influence the length of disability following pancreatectomy include age of individual, amount and location of pancreatic tissue removed, any concurrent infections, overall health, and other complicating diseases.

Medical Codes

ICD-9-CM:
52.51 - Pancreatectomy, Proximal; Excision of Head of Pancreas (with Part of Body); Proximal Pancreatectomy with Synchronous Duodenectomy
52.52 - Pancreatectomy, Distal; Excision of Tail of Pancreas (with Part of Body)
52.53 - Pancreatectomy, Radical Subtotal
52.59 - Pancreatectomy, Other, Partial
52.6 - Total Pancreatectomy; Pancreatectomy with Synchronous Duodenectomy

Overview

Pancreatectomy is the surgical removal of a part of or the entire pancreas.

Removal of the entire pancreas (total pancreatectomy) takes out the whole pancreas, part of the small intestine, part of the stomach, the bile duct, gallbladder, spleen, and most of the lymph nodes in the area. Organs other than the pancreas may be preserved when the procedure is performed for a non-cancerous (benign) condition.

The surgeon will remove only a part of the pancreas (subtotal or partial pancreatectomy) whenever it is medically allowable. This approach permits the remaining pancreas to secrete important digestive enzymes into the intestine and critical hormones (insulin, glucagon) into the bloodstream.

Diseases that obstruct the pancreatic duct may require partial pancreatectomy. This involves removal of the narrow end of the pancreas lying near the spleen (tail of the pancreas) and surgically linking the duct into the small intestine (distal pancreatectomy). Partial pancreatectomy is also performed for diseases located in the broad end of the pancreas situated in a loop of the small intestine (head of the pancreas). This procedure may necessitate removal of the head of the pancreas, part of the small intestine, and some of the tissues around it (Whipple procedure).

Source: Medical Disability Advisor



Reason for Procedure

Pancreatectomy is performed to remove part or all of the pancreas and surrounding diseased organs. The most common reasons for the procedure include localized pancreatic cancer, acute or chronic inflammation of the pancreas (pancreatitis) that does not respond to medical treatment, cancer of the small chamber formed by the union of the common bile duct and pancreatic duct (ampulla of Vater), pancreatic trauma, pancreatic cysts, and cancer of the stomach or large intestine that has metastasized into the pancreatic tail. A pancreatectomy may also be done to treat hormone-secreting tumors (insulinomas).

Pancreatectomy is the only treatment option for pancreatic cancer.

Source: Medical Disability Advisor



How Procedure is Performed

Pancreatectomy is a major surgical procedure requiring a hospital stay.

The procedure is performed under general anesthesia. It involves making an incision across and through the upper abdominal wall to expose the pancreas and other abdominal organs, as needed. The procedure requires that a part of or the entire pancreas be removed (resected) surgically. Blood vessels (arteries, veins) and other ducts (lymphatics, pancreatic and bile ducts) are tied off as the pancreas and other organs are removed. The intestines are reconnected, although the anatomy may be altered by the procedure. The skin is closed with sutures or staples.

The individual stays in the hospital for an average of 16 days.

Source: Medical Disability Advisor



Prognosis

The predicted outcome for individuals treated for pancreatic cancer using partial or total pancreatectomy is very poor, with a 5-year survival rate of less than 5% following diagnosis and treatment (Erickson). Individuals with acute or chronic inflammation of the pancreas (pancreatitis) who are treated with partial or total pancreatectomy have an operative mortality of 4% and 10%, respectively. Pain relief is experienced initially in as many as 75% of individuals with pancreatitis receiving this treatment (Helwick). Other conditions treated using partial pancreatectomy (i.e., pancreatic trauma or cysts and insulinoma) have a postoperative mortality rate ranging from 5% to 22%.

The risk of undergoing pancreatectomy varies with the extent of the surgery and the experience of the surgeon. In general, mortality rates from surgical complications range between 2% and 15%. The lower risk rates (2% to 5%) are found in cancer centers under the guidance of experienced surgeons ("Detailed Guide").

Source: Medical Disability Advisor



Rehabilitation

Long-term rehabilitation is not usually a consideration for most individuals who have had total pancreatectomy, because the diseases associated with this treatment are most often fatal. For those individuals who have had partial pancreatectomy, intermittent positive pressure breathing exercises may be useful in preventing postoperative pulmonary complications. Certain exercises help reduce postoperative pain and speed recovery, including progressive relaxation and deep-breathing techniques. These exercises may be performed several times a day until pain from inhalation/exhalation is less noticeable. Ankle flexes, knee bends, and crossed-leg muscle contractions (all while lying on the back) help increase circulation and make walking easier and are especially valuable during the first 48 hours after surgery. Individuals may continue with these exercises for 4 to 6 weeks, until recovery from surgery is complete and pain is no longer noticeable while walking or breathing.

Source: Medical Disability Advisor



Complications

Complications following pancreatectomy may be as high as 41%; postoperative bleeding (hemorrhage) alone may result in mortality rates approaching 50% (Helwick). Other complicating factors are organ failure (hypovolemic shock), kidney-liver (hepatorenal) failure, postoperative infection of the incision wound, infection of the abdominal cavity (sepsis), inability to digest food properly, and inability to control blood sugar levels (diabetes). Because the pancreas secretes digestive enzymes, leakage following surgery may result in the digestion of surrounding tissue. Delayed gastric emptying is a frequent complication following a total pancreatectomy in which the first part of the small intestine as well as the pancreas is removed. Anticipating this problem, the surgeon may insert an external feeding tube to maintain the patient's nutrition.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Individuals require more sedentary work for a period of time due to weakness and fatigue following surgery. Medium to heavy-duty responsibilities should be postponed. As a precaution following any open abdominal surgery, the patient should postpone heavy lifting or straining for 6 to 8 weeks.

Source: Medical Disability Advisor



References

Cited

"Detailed Guide: Pancreatic Cancer." American Cancer Society. 14 Sep. 2004 <http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?rnav=cridg&dt=34>.

Erickson, R. A. "Pancreatic Cancer." eMedicine. Eds. Lodovico Balducci, et al. 16 Jul. 2004. Medscape. 14 Sep. 2004 <http://emedicine.com/med/topic1712.htm>.

Helwick, Caroline A. "Pancreatectomy." Health A to Z. 14 Sep. 2004. 9 May 2005 <http://www.healthatoz.com>.

Source: Medical Disability Advisor






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