Pancreatic cancer

Surgery

Pancreatic cancer

Surgery

Surgery involves removing tissues or organs from the body. The type of surgery you have depends on your cancer. You may also hear surgery called an operation or a procedure.

Every operation is different. Ask your surgeon about what to expect.

Pancreatic cancer surgery is complex and should be done at a specialist centre. 

See our Canrefer website for a list of specialist centres in NSW.

What you need to know

Pancreatic cancer surgery

When pancreatic cancer is diagnosed early, it is possible to have surgery to remove the cancer. However, most pancreatic cancers are diagnosed when they have already spread to other organs. In this situation, surgery and other procedures can help to control the cancer or its symptoms.

Surgery and procedures for pancreatic cancer include:

Whipple procedure

  • This is the most common surgery to remove pancreatic cancer.
  • It is also known as a pancreatectomy or a pancreaticoduodenectomy.
  • It involves removing parts of the pancreas, small intestine and gallbladder.
  • It is a major operation.
  • There are a few variations of this surgery that may have different names.

Debulking surgery

  • This is used for people with more extensive disease to cut out as much of the cancer as possible.
  • It can slow the growth of the cancer and relieve some of the symptoms.
  • It is only used for endocrine tumours (PNETs).

Biliary bypass surgery or stent placement

  • These are used for symptom control.
  • They allow drainage of bile and relieve symptoms of jaundice.

Coeliac plexus block

  • This is a palliative procedure.
  • An anaesthetic is injected into the coeliac plexus to help reduce pain in the upper abdomen.

Ablation

  • Ablation treatments are used to destroy cancer cells.
  • Radiofrequency ablation uses high energy radio waves to heat and destroy cancer cells.
  • Cryosurgery or cryoablation freezes the cancer cells.

Embolisation

  • In this procedure, chemotherapy is administered directly into the cancer, through an artery.
  • It is also known as trans-arterial chemoembolisation (TACE).

Your surgeon will discuss with you when and where you can have your operation, and any costs involved. They will also give you instructions about what to do before your surgery and what to expect afterwards.

The surgical team

Health professionals who work as part of the surgical team include:

  • surgeon
  • anaesthetist
  • nurse
  • allied health professional.

What to ask or talk about

Side effects of pancreatic surgery

Your surgeon will discuss any risks of the surgery with you before your operation. Most hospitals will also give you written information about the surgery and who to contact if you have any concerns.

Possible side effects and complications from any surgery include:

  • pain
  • infection
  • bleeding
  • tiredness (fatigue)
  • loss of appetite
  • blood clots.

Possible side effects and complications of pancreatic surgery include:

  • Fluid leak (anastomotic leak) - When the internal joins don’t heal properly and gut contents (bile, stomach acid or pancreatic juices) leak out.
  • Delay in the emptying of the stomach - When food stays in the stomach and causes bloating, nausea and vomiting. It is caused by damage to the stomach nerves.
  • Dumping syndrome - Food isn’t digested properly and passes through the stomach too quickly. This can cause stomach cramps and diarrhoea after eating.
  • Problems with food absorption - A reduction in pancreatic enzymes make it harder to digest food. If this happens you will need medication to help you absorb food.
  • Dehydration - Happens when you don’t get enough fluids. It is usually caused by vomiting or diarrhoea.
  • Diabetes - Can happen when the cells that make insulin are removed. If this happens you may need insulin injections.

The surgical team looking after you during and after your operation will take care to reduce your risk of side effects, and treat any that you get.

Every operation is different. Ask your surgeon about what to expect and see our checklist of questions to ask.

Checklists

Use our checklists to find helpful tips or questions to ask.

Next steps

Preparing for surgery

Before surgery, you will need to sign a consent form. It is important you understand what you are consenting to and the possible risks of the surgery.

Some things you should know are:

  • whether you need to have tests and a preoperative assessment
  • whether you need to change or stop any medications, e.g. blood thinners like aspirin
  • when you have to stop eating and drinking
  • when you have to be there
  • whether you need time off work
  • whether you need someone to care for you at home after surgery (if you are having day surgery you will need someone to drive you home).
If you smoke, you should stop before any operation as your risk of complications from surgery is higher.

Where to get help

There are people you can talk to for more information or support.

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