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Surgery for pancreatic cancer

Pancreaticoduodenectomy; Whipple procedure; Open distal pancreatectomy and splenectomy; Laparoscopic distal pancreatectomy; Pancreaticogastrostomy

Pancreatic surgery is done to treat cancer of the pancreas gland.

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Description

The pancreas is located behind the stomach, between the duodenum (the first part of the small intestine) and the spleen, and in front of the spine. It helps in food digestion. The pancreas has three parts called the head (the wider end), middle, and tail. All or part of the pancreas is removed depending on the location of the cancer tumor.

Whether the procedure is performed laparoscopically (using a tiny video camera) or using robotic surgery depends on:

The surgery is done in the hospital with general anesthesia so you are asleep and pain free. The following types of surgeries are used in the surgical treatment of pancreatic cancer.

Whipple procedure -- This is the most common surgery for pancreatic cancer.

Distal pancreatectomy and splenectomy -- This surgery is used more often for tumors in the middle and tail of the pancreas.

Total pancreatectomy -- This surgery is not done very often. There is little benefit of taking out the whole pancreas if the cancer can be treated by removing only part of the gland.

Why the Procedure Is Performed

Your doctor may recommend a surgical procedure to treat cancer of the pancreas. Surgery can stop the spread of cancer if the tumor has not grown outside the pancreas.

Risks

Risks for surgery and anesthesia in general are:

Risks for this surgery are:

Before the Procedure

Meet with your doctor to make sure medical problems such as diabetes, high blood pressure, and heart or lung problems are in good control.

Your doctor may ask you to have these medical tests done before your surgery:

During the days before the surgery:

On the day of the surgery:

After the Procedure

Most people stay in the hospital 1 to 2 weeks after surgery.

After you go home:

You may require further treatment after you recover from surgery. Ask your doctor about your situation.

Outlook (Prognosis)

Pancreatic surgery can be risky. If surgery is done, it should take place at a hospital where many of these procedures are performed.

References

Jesus-Acosta AD, Narang A, Mauro L, Herman J, Jaffee EM, Laheru DA. Carcinoma of the pancreas. In: Niederhuber JE, Armitage JO, Kastan MB, Doroshow JH, Tepper JE, eds. Abeloff's Clinical Oncology. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 78.

Pucci MJ, Kennedy EP, Yeo CJ. Pancreatic cancer: clinical aspects, assessment, and management. In: Jarnagin WR, ed. Blumgart's Surgery of the Liver, Biliary Tract, and Pancreas. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 62.

Shires GT, Wilfong LS. Pancreatic cancer, cystic pancreatic neoplasms, and other nonendocrine pancreatic tumors. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 60.

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Review Date: 5/27/2019  

Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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