Small Intestine Cancer Surgery
Small intestine cancer occurs when abnormal cells grow uncontrollably in the small bowel, a vital part of the digestive system responsible for nutrient absorption. While the exact cause is not always clear, known risk factors include chronic bowel inflammation, colorectal polyps and unhealthy lifestyle practices, such as smoking.
Symptoms of small intestine cancer can include abdominal pain, unexplained weight loss, nausea, vomiting, blood in the stool and changes in bowel habits, such as persistent diarrhea or constipation. Treatment often involves a combination of surgery, chemotherapy and sometimes radiation therapy, depending on the stage and location of the tumor. The primary treatment for early-stage small intestine cancer is surgical removal of the tumor, which may be followed by chemotherapy to help prevent recurrence.
Surgical treatment options for small intestine cancer may include:
Pancreaticoduodenectomy (Whipple procedure) for small intestine cancer
The Whipple procedure is a complex surgery primarily used to treat pancreatic cancer. However, it can also be used to treat a tumor in the first part of the small intestine (duodenum) near the pancreas. This major surgical procedure involves removing:
- The head of the pancreas
- The duodenum
- A portion of the bile duct
- The gallbladder
- Some nearby lymph nodes
After removing these organs and tissues, the surgeon will reconnect parts of the digestive system to allow for the passage of food. The remaining portion of the small intestine will be attached to the stomach, while the bile duct and pancreatic duct will be rerouted to the small intestine, restoring normal digestive function.
Services and features at Moffitt McKinley Hospital include:
- Surgery operating and recovery rooms
- Radiology/diagnostic imaging
- Pathology and laboratory
- Publix Pharmacy
- Ancillary clinical services
- Patient and Family Center
- Café and cafeteria
- Gift shop
How to prepare for a Whipple procedure for small intestine cancer
Preparing for pancreaticoduodenectomy involves several steps. The patient will first undergo a thorough evaluation, including imaging and blood work, to ensure their readiness for surgery. The surgeon will provide detailed preoperative instructions, which may include adjusting certain medications, following a special diet, fasting for several hours and preparing the bowel to clear the intestines. The patient will also meet with the anesthesiologist to discuss the anesthesia plan. Emotional and psychological preparation is also key to the success of a Whipple procedure, and many patients find it helpful to speak with a counselor beforehand.
What to expect after a Whipple procedure for small intestine cancer
After pancreaticoduodenectomy, the patient will be closely monitored in the hospital for one to two weeks. Initially, the patient may be placed in the intensive care unit (ICU) to recover from the effects of the anesthesia and surgery. A nasogastric (NG) tube may be used to remove the contents of the stomach until normal digestion resumes, and the patient will receive fluids and nutrition through an intravenous (IV) line. It may be several days or longer before the patient can begin eating solid foods.
Pain management is usually a key focus of recovery, and medications will be provided to help keep any post-surgical discomfort under control. Fatigue and weakness are common after a Whipple procedure, and these effects should gradually improve with time.
Once at home, the patient can expect to slowly increase their activity level, follow a low-fat or easily digestible diet and attend follow-up appointments to monitor their recovery. Possible long-term effects of pancreaticoduodenectomy include changes in digestion or the need to take enzyme supplements to help with nutrient absorption. While full recovery can take up to several months, most patients resume their normal activities with appropriate care and support.
What are the risks and potential complications of a Whipple procedure for small intestine cancer?
Pancreaticoduodenectomy is a complex procedure that carries several risks and potential complications. These include infection, excessive bleeding and delayed stomach emptying, which may result in nausea and vomiting. Digestive issues such as diarrhea and nutrient malabsorption can also occur, often requiring enzyme supplements. Though rare, possible complications include leaks at the surgical connections, blood clots and diabetes, particularly if a significant portion of the pancreas was removed. While these risks can be serious, skilled surgical care and careful post-operative monitoring can significantly reduce their likelihood.
Bowel resection surgery for small intestine cancer
A common treatment for localized cancer, bowel resection surgery involves removing the section of the small intestine that contains the tumor along with some nearby lymph nodes. After excising the cancerous tissues, the surgeon will reconnect the remaining healthy ends of the small intestine (anastomosis) to restore the continuity of the bowel and allow for normal digestion and stool passage. Depending on the case, this procedure can be performed using minimally invasive laparoscopic or traditional open surgical techniques.
How to prepare for bowel resection surgery for small intestine cancer
Preparing for bowel resection surgery involves several steps. The surgeon will begin with a comprehensive presurgical evaluation, including blood work and imaging, to assess the patient’s health and plan the procedure. Typically the patient will be advised to stop eating and drinking several hours before surgery, bathe with an antiseptic wash and adjust certain medications, such as blood thinners. Additionally, bowel preparation may be required to clear the intestines. The patient will also need to arrange for support at home during their recovery.
What to expect after bowel resection surgery for small intestine cancer
After bowel resection surgery, the patient can expect to remain in the hospital for several days for close monitoring. Initially, they may have an NG tube in place to drain the stomach contents and an IV line to provide fluids and nutrition until the digestive system resumes function. Discomfort and fatigue are common during the initial phase of recovery, but any pain can usually be managed with medication.
The patient’s diet will be reintroduced gradually, starting with clear liquids and advancing to solid foods as tolerated. It may take some time for bowel movements to return to normal. While physical activity will be limited at first, gentle movements, such as walking, can help prevent blood clots and other complications. Full recovery may take up to several weeks, and follow-up appointments will be necessary to monitor healing and assess the need for further treatment.
What are the risks and potential complications of bowel resection surgery for small intestine cancer?
Bowel resection surgery carries certain risks, including infection, excessive bleeding and leaks at the anastomosis site, which can lead to sepsis, a potentially life-threatening complication. Some patients may experience digestive changes, such as diarrhea, constipation or nutrient malabsorption. Other potential complications include blood clots and adhesions, which can cause discomfort or lead to future issues. However, precise surgical techniques and comprehensive post-operative care can significantly reduce the risk of complications and support a full recovery.
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Schedule an AppointmentBypass surgery for small intestine cancer
Bypass surgery may be considered if an inoperable tumor causes a blockage in the small intestine. During the procedure, the surgeon will create an alternate pathway for food and digestive fluids to bypass the obstructed section of the intestine. Although this surgery does not remove the tumor, it can alleviate symptoms caused by the blockage, such as nausea, vomiting and pain, improving the patient’s quality of life.
How to prepare for bypass surgery for small intestine cancer
Preparing for bypass surgery to address a small intestine cancer blockage involves several key steps. The surgeon will conduct a thorough preoperative evaluation, including blood tests and imaging studies, to plan the procedure. The patient will be advised to stop smoking immediately (if applicable), follow a clear liquid diet the day before surgery and pause certain medications, especially blood thinners. To ensure a clear surgical field, bowel preparation may be needed, which usually involves laxatives or enemas to empty the intestines. Emotional preparation for bypass surgery can help ease the process, so the patient should discuss any concerns with their healthcare team. Adhering to these guidelines can help ensure a smooth surgical experience and recovery.
What to expect after bypass surgery for small intestine cancer
After bypass surgery, the patient will likely remain in the hospital for several days for close monitoring. Initially, they may receive nutrition and fluids through an IV line while their digestive system recovers, and an NG tube will drain the stomach contents and help prevent nausea. Any pain can usually be managed with medication, and some fatigue and discomfort are normal as the body heals.
The patient’s diet will be reintroduced gradually, starting with clear liquids and advancing to soft or solid foods as tolerated. Recovery may take several weeks, during which light physical activity, such as walking, will be encouraged to help prevent complications like blood clots. Follow-up appointments will be necessary to monitor healing and address any ongoing symptoms or concerns.
What are the risks and potential complications of bypass surgery for small intestine cancer?
Bypass surgery carries certain risks, such as infection, excessive bleeding and leaks at the intestinal connections, which can cause inflammation of the peritoneum (peritonitis). Scar tissue may develop and create new bowel obstructions, and many patients experience digestive changes, such as diarrhea, constipation or nutrient absorption. There is also a slight risk of blood clots forming in the legs and traveling to the lungs. Despite the risks and potential complications, bypass surgery is often successfully used to relieve symptoms and improve the quality of life for patients with advanced small intestine cancer.
Robotic-assisted surgery for small intestine cancer
Robotic surgery is performed with the assistance of an advanced robotic system, such as the da Vinci Surgical System, which can help the surgeon carry out highly complex, minimally invasive techniques with unprecedented precision. While operating, the surgeon can meticulously maneuver robotic arms via a console, which also provides high-definition, 3D images of the surgical site in real-time. This approach can be used for Whipple, tumor removal, bowel resection or bypass surgery, potentially allowing for smaller incisions, reduced blood loss, less pain and a faster recovery compared to traditional open surgery.
Benefit from world-class care at Moffitt Cancer Center
A small intestine cancer diagnosis can seem overwhelming. The multispecialty team in Moffitt’s high-volume Gastrointestinal Oncology Program is committed to providing comprehensive and compassionate cancer care. In a single location, our patients can benefit from the latest diagnostic and treatment techniques, state-of-the-art technologies, nationally recognized research and promising clinical trials.
If you would like to learn more about small intestine cancer surgery, you can request an appointment with a specialist in the Gastrointestinal Oncology Program at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.
Helpful Links:
Traditional vs. Robotic Small Bowel Resection
Traditional vs. Robotic Duodenal Resection
Traditional vs. Robotic Ampullectomy