Surgery Treatment for Pancreatic Cancer

Surgery for pancreatic cancer may be used to help treat the cancer or to help relieve symptoms such as blocked bile ducts or intestine.

Only about 10% of pancreatic cancers are contained entirely within the pancreas at the time of diagnosis. Attempts to remove the entire cancer may be successful in some patients. But even when the cancer seems to have not spread, cancer cells too few to detect may have spread to other parts of the body.

The main types of surgery for pancreatic cancer are:

  • Curative: attempt to treat cancer by removing it

  • Palliative: attempt to relieve symptoms and make you more comfortable

Curative Surgeries

Pancreaticoduodenectomy is the most common surgery to attempt to remove a pancreatic tumor. Also known as the Whipple procedure, this operation removes:

  • Head of the pancreas 
  • Body of the pancreas (in some patients)
  • Part of the stomach 
  • Duodenum (first part of the small intestine) 
  • A small portion of the jejunum (second part of the small intestine) 
  • Lymph nodes near the pancreas 
  • Gallbladder 
  • Part of the common bile duct

This major operation carries a high risk of complications, even when it is performed by experienced surgeons. About 30% to 50% of patients suffer complications, including leakage from surgical connections, infections and bleeding.

The surgery takes from six to 12 hours and requires a seven- to 10-day stay in the hospital. You may need nutritional support with a feeding tube or through a vein. Recovery will take about a month. It will be three months before your digestive system works well again.

Distal pancreatectomy removes only the tail of the pancreas, or the tail and a part of the body of the pancreas. The spleen usually is removed as well. This operation is used more often with islet cell tumors.

Total pancreatectomy, which removes the entire pancreas and the spleen, was once used for tumors in the body or head of the pancreas. However, when the entire pancreas is removed, patients are left without islet cells, which produce insulin. They develop hard-to-manage diabetes and become dependent on injected insulin. Studies have not shown any advantage to removing the whole pancreas.

Palliative Surgeries

Surgical techniques to help relieve symptoms of pancreatic cancer include:

  • Stent placement: Metal tubes that help keep the bile duct open are inserted, avoiding blockage. This procedure is used more often than biliary bypass. Stents may be placed with an endoscope.
  • Biliary bypass: The surgeon makes a cut in the gallbladder or bile duct and then sews it to the small intestine. This helps when a tumor is blocking the small intestine and causing bile to build up in the gallbladder. This surgery also may help relieve pain.
  • Gastric bypass: When pancreatic cancer blocks the stomach, the stomach may be sewn to the small intestine, allowing you to eat normally.