Surgical Procedures for Pancreatic Cancer

Surgery is the main way to treat pancreatic cancer. The goal is to remove as much cancer as possible. This will help keep as much of the pancreas, and how it works, intact. The type of surgery depends on the cancer stage and your level of health.

When the pancreas is removed, the body can no longer make insulin. This controls the level of glucose in your blood. To keep it under control, you will need insulin shots. You may also need an enzyme pill. It's taken with meals to help your body break down the foods you eat.

Surgeries on the pancreas are long and difficult. There are often serious health problems after them. If you need any of these, it will need to be done by a surgeon in a hospital with experience.

Depression is a common problem with pancreatic cancer. During a hospital stay, you may have counseling.

Surgery for Resectable and Borderline Resectable Pancreatic Cancer

Cancer at these stages are most likely able to be cured with surgery. The type of you need will depend on the size of the tumor and where it's found.

These may involve:

Pancreaticoduodenectomy (Whipple Procedure)

A Whipple procedure is the most common type of surgery. But, it's also very complex. It involves removing:

  • The head and body of the pancreas
  • All the stomach or the lower part of the stomach
  • The first and second sections of the small intestine
  • Nearby lymph nodes
  • The gallbladder
  • The common bile duct

Parts of the stomach and small intestine are attached together so food can pass through the digestive tract.

Pancreatectomy

This may involve taking out all, or just the tail of, the pancreas. If just the tail is removed, the spleen is taken out as well. This type is done for certain types of cancer.

A total pancreatectomy involves removing:

  • The pancreas
  • Gallbladder
  • Spleen
  • Lymph nodes
  • Parts of the small intestine and stomach

You can live without a spleen. But, not having one makes it harder for the body to fight infection. You can protect yourself by keeping up with vaccines and making changes in your life.

Nutritional support may be needed after surgery. The type depends on how much surgery you had.

Palliative Surgery for Unresectable Pancreatic Cancer

Some measures can be taken to ease health problems and make your life better. As cancer grows, it blocks the body from working as it should. Most of these are done during an endoscopy.

  • Stent —A stent can be used to open an area that may be blocked by a tumor or a collapsed duct. A biliary stent is used in the common bile duct and an enteral stent is used in the stomach or small intestine.
  • Biliary bypass —An opening is made between the gallbladder and part of the small intestine. This allows bile to flow around the pancreas and into the small intestine.
  • Gastric bypass —If the stomach is blocked and food can't move normally, the stomach can be directly connected to the small intestine.
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References:

De La Cruz MD, Young AP, Ruffin MT. Diagnosis and management of pancreatic cancer. Am Fam Physician. 2014;89(8):626-632.
Pancreatic cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/pancreatic-cancer. Updated October 2017. Accessed October 25, 2018.
Pancreatic resection and procedural variations. EBSCO DynaMed Plus website. Available at: https://www.dyname.... Updated October 11, 2018. Accessed October 25, 2018.
Surgery for pancreatic cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/pancreatic-cancer/treating/surgery.html. Updated May 31, 2016. Accessed October 25, 2018.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/pancreatic/patient/pancreatic-treatment-pdq#section/_162. Updated May 23, 2018. Accessed October 25, 2018.
9/18/2007 DynaMed Plus Systematic Literature Surveillance https://www.dyname...: Küchler T, Bestmann B, Rappat S, Henne-Bruns D, Wood-Dauphinee S. Impact of psychotherapeutic support for patients with gastrointestinal cancer undergoing surgery: 10-year survival results of a randomized trial. J Clin Oncol. 2007;25(19):2702-2708.
Last reviewed September 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 10/25/2018

 

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