Pancreatic Cancer Surgery
Pancreatic cancer begins in the tissues of the pancreas, a dual-role organ located behind the stomach. As part of the gastrointestinal tract, the pancreas produces enzymes that aid the digestion of food, particularly proteins. As part of the endocrine system, the pancreas produces insulin, a hormone that helps control blood sugar levels.
Most pancreatic tumors form in the cells that line the pancreatic ducts. If left untreated, the cancer can quickly spread to nearby tissues and organs. Because its early symptoms can be subtle and nonspecific—such as abdominal pain, loss of appetite, unintended weight loss and jaundice—pancreatic cancer is often diagnosed at an advanced stage, which can complicate its treatment. Early detection is the key to ensuring prompt and effective treatment, which can lead to the best possible outcome and quality of life. Options may include surgery, chemotherapy and/or radiation therapy.
Why is pancreatic cancer surgery performed?
Pancreatic cancer surgery is performed to remove the tumor from the pancreas, which can help control cancer spread. Surgical treatment may be considered if the tumor is localized and has not metastasized to distant organs. The goal is to completely remove the tumor, which can potentially lead to long-term remission or cure. In some cases, surgery may also be performed to alleviate the symptoms of advanced pancreatic cancer and improve the patient’s quality of life.
Who is a good candidate for pancreatic cancer surgery?
Typically, a good candidate for pancreatic cancer surgery has a localized tumor that is confined to the pancreas and has not spread to major blood vessels or distant organs. The surgeon will also consider the size and location of the tumor and the patient’s age and nutritional status. The patient should be in good overall health with sufficient heart, lung and liver function to withstand the stress of major surgery.
How to prepare for pancreatic cancer surgery
To prepare for pancreatic cancer surgery and help ensure a smooth recovery, the patient should:
- Undergo preoperative testing – The surgical team may recommend imaging, blood work and cardiac and pulmonary evaluations to help ensure the patient is fit for surgery.
- Meet with the surgical team – The surgeon, anesthesiologist and possibly a nutritionist and physical therapist will explain the procedure, anesthesia, postoperative care and recovery plan.
- Make lifestyle adjustments – The surgical team may suggest quitting smoking, eating a nutritious diet and engaging in light physical activity before pancreatic cancer surgery to promote good health and optimal healing.
- Discuss all current medications with the surgical team – After reviewing the patient’s medication use, the surgical team will explain which drugs should be stopped or adjusted before surgery.
- Fast – The surgical team will provide preoperative fasting guidelines, typically beginning the night before surgery, to ensure an empty stomach during the procedure.
- Arrange support – The patient should ask someone to drive them to and from the hospital, assist them at home afterward and help with daily activities during their recovery.
- Pack essentials – The patient should prepare a bag with personal items, comfortable clothing and any medical supplies they may need during their hospital stay.
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What happens during pancreatic cancer surgery?
The optimal surgical treatment approach for pancreatic cancer can vary depending on the location of the tumor and other factors. A tumor in the head of the pancreas generally requires a Whipple procedure (pancreaticoduodenectomy), which involves removing the head of the pancreas, part of the small intestine, the gallbladder and a portion of the bile duct.
A tumor in the body or tail of the pancreas may require a distal pancreatectomy, which involves removing the body and tail of the pancreas, often along with the spleen, but leaves the head of the pancreas intact. In advanced cases, a total pancreatectomy may be considered, which involves removing the entire pancreas along with parts of the stomach, small intestine, bile duct, gallbladder and possibly the spleen.
In general, pancreatic cancer surgery involves:
- Anesthesia – The patient will receive general anesthesia to ensure they remain unconscious throughout the procedure.
- Incisions – The surgeon will make a few incisions in the abdomen to access the pancreas.
- Tumor removal – To remove the tumor and other affected tissues, the surgeon may perform a Whipple procedure, distal pancreatectomy or total pancreatectomy.
- Reconstruction – After removing the tumor, the surgeon will connect the remaining parts of the pancreas, bile duct and intestines to restore the flow of food, bile and digestive enzymes through the digestive tract.
- Closure of incisions – The surgeon will close the incisions with sutures or staples and apply dressings to the surgical site.
In some cases, minimally invasive (laparoscopic) pancreatic cancer surgery may be considered. After making a few small incisions in the abdomen, the surgeon will insert special, telescope-guided surgical instruments to remove the tumor and some surrounding tissues. Laparoscopic pancreatic surgery can also be performed with robotic assistance for heightened surgical precision.
What are the risks and possible complications of pancreatic cancer surgery?
Pancreatic cancer surgery, like any major procedure, comes with some risks and potential complications. These include infection at the surgical site or within the abdomen, bleeding during or after the surgery and temporary difficulty in stomach emptying, which may cause nausea and vomiting.
After pancreatic cancer surgery, the patient may need to take enzyme supplements to aid digestion. They may also be at risk of nutritional deficiencies due to changes in the digestive process. These risks will be carefully managed by the surgical team through close postoperative monitoring and appropriate medical care.
What to expect during recovery from pancreatic cancer surgery
After pancreatic cancer surgery, the patient can expect to remain in the hospital for one to two weeks so they can receive pain management, nutritional support and physical therapy as needed to regain their strength and promote healing. Eating will initially be limited to liquids or soft foods, with solid foods gradually introduced as the body adjusts to the newly configured digestive system.
During recovery, the patient may experience some discomfort and fatigue, and it will be important to follow their surgeon’s postoperative guidelines, attend their follow-up appointments and gradually increase their physical activity. Full recovery can take up to several months, and the surgical team will provide ongoing support to help manage any digestive changes and ensure a smooth recovery process.
How effective is pancreatic cancer surgery?
Pancreatic cancer surgery can be effective, particularly when the tumor is detected early and has not spread extensively. In many cases, surgical treatment offers the best chance for long-term survival and potential cure by removing the tumor and any affected tissues. For enhanced treatment effectiveness, pancreatic cancer surgery is often performed as part of a comprehensive treatment plan that also includes chemotherapy and/or radiation therapy.
Benefit from world-class care at Moffitt Cancer Center
Moffitt is recognized among the “Best Hospitals for Cancer” in the United States. The surgeons in our renowned Gastrointestinal Oncology Program have extensive experience in performing complex gastrointestinal procedures, including pancreatic cancer surgery. We also offer promising new treatment options through our robust portfolio of clinical trials.
If you would like to learn more about pancreatic cancer surgery, you can request an appointment with a specialist at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.
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