Pancreatic cancer surgery removes the tumor with the affected part of the pancreas, sometimes with neighboring tissue and lymph nodes, as part of a multidisciplinary plan. It is performed when the team judges the tumor removable, and aims to remove the tumor as completely as possible within a comprehensive plan; a cure cannot be promised.
The type of operation depends on where the tumor lies. The Whipple procedure, used for tumors in the head of the pancreas, removes the pancreatic head, duodenum and part of the bile duct, sometimes part of the stomach, and the digestive tract is then reconnected. Distal pancreatectomy, used for tumors of the body and tail, may include removing the spleen. Both are done under general anesthesia, by open surgery or, in selected cases, laparoscopy or robot.
The operation usually takes several hours and often needs one to two weeks in hospital. Recovery takes weeks, and activity then returns gradually over a few months, with further treatment and follow-up set by the team.
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Surgery can remove the tumor when it is removable, and it is often combined with chemotherapy or radiotherapy. The treating team decides the plan for each case, and no particular outcome can be promised.
It depends on the tumor's size and location, its relationship to nearby blood vessels, how far it has spread and the patient's general health. Suitability is decided after imaging, tests and review by the medical team, and in some cases treatment is given before surgery.
Preparation includes tests, imaging and assessment of nutrition, heart and lungs, and may involve relieving a blocked bile duct or improving nutrition beforehand. The team gives precise instructions on medication, fasting and stopping smoking.
It is done under general anesthesia. In a Whipple procedure the pancreatic head, duodenum and part of the bile duct, and possibly part of the stomach, are removed, then the pancreas, bile duct and bowel are reconnected. In distal pancreatectomy the body and tail are removed and the spleen may be removed too. The surgeon decides the appropriate method.
Hospital stay is usually about one to two weeks, with gradual return to eating and pain relief, and antibiotics or enzyme replacement may be needed. Full recovery takes weeks to months.
The removed tumor is examined under the microscope after the operation, and the team bases the plan for further treatment and follow-up on that report. Weight and activity return gradually, and no outcome is guaranteed.
They include bleeding, infection, leakage from the pancreatic connection (pancreatic fistula), delayed stomach emptying and blood clots. Digestive problems needing enzyme tablets, or raised blood sugar, may appear later, especially after a large part of the pancreas is removed.
Open surgery leaves an incision in the upper abdomen that heals over time, while laparoscopic and robotic approaches leave several small wounds. Scarring varies from person to person.
Patients usually need weeks after leaving hospital before flying, and often not less than two to three weeks after surgery. The treating doctor confirms the right time after examining you.
Many patients need further treatment such as chemotherapy once they have recovered, and the team decides this according to the microscope findings. Follow-up includes periodic examinations, imaging, blood tests and nutritional support.
