What happens after surgery?

How quickly you recover will depend on the type of operation you’ve had. Most people will be nursed in an intensive care or high-dependency unit for a few days after surgery.

The nurses will encourage you to start moving around as soon as possible.

You may have some drips and drainage tubes after surgery. You will need painkilling drugs for a few days.

The most common complications after surgery are:

  • a wound infection
  • bleeding in the operation area
  • a chest infection
  • a blood clot.

The nurses will monitor you for these complications. Let them know straight away if you have any bleeding, feel unwell, have symptoms of an infection such as a cough or discharge from your wound, or swelling and redness in a limb.

After surgery to the pancreas, your body may not make enough insulin to control your blood sugar. You may need to have insulin injections. You may also need to take capsules containing digestive enzymes. These help your body to break down and absorb fats and protein.

After surgery

Knowing what will happen when you wake up after your operation can help you feel less anxious. It also prepares your family and friends for what to expect. How quickly you recover will depend on the type of surgery you’ve had.

Most people will be nursed in an intensive care or high-dependency unit for a few days after their operation. This is routine and doesn’t mean your operation has gone badly or that there are complications. A machine called a ventilator may be used to help you to breathe for a few hours – again, this is routine in some hospitals. You will probably feel quite drowsy and may not remember much about the first day or two after your operation.

The nurses will encourage you to start moving about as soon as possible. This is an important part of your recovery, as it helps to prevent problems such as chest infections or blood clots. If you have to stay in bed, the nurses will encourage you to do regular leg movements and deep breathing exercises. A nurse or a physiotherapist can help you do the exercises.

The ward staff will help you during this time as you may need help to wash and go to the toilet. Once you are moving about more freely, you’ll probably be able to manage this for yourself.

If you’re in an enhanced recovery programme or have had laparoscopic (keyhole) surgery, your nurse will encourage you to get out of bed and start moving around as soon as possible.


Drips and drains

For a short time after the operation, you may have some of the following:

  • A drip going into a vein in your arm or neck (intravenous infusion). This will give you fluids until you are able to eat and drink again. It may also be used to give you painkillers.
  • One or more drainage tubes coming from your wound to drain away fluid or blood, or to drain away bile or pancreatic fluid. The drainage tubes will be removed when the amount of fluid draining away has reduced.
  • A fine tube that passes down your nose and into your stomach or small intestine. This is called a nasogastric tube. It drains fluids from your stomach so that you don’t feel sick. You may need this for several days.
  • A small flexible tube (catheter) to drain urine from your bladder into a collecting bag. This means you won’t have to get up to pass urine. It is usually taken out after a couple of days.
  • A feeding tube that goes into the small bowel through a small cut in the abdomen. It is used to give you food and nutrients until you’re able to eat again.


Wound care

The wound is closed using clips or stitches. These are usually removed 7–10 days after your operation. Some surgeons use dissolving stitches that don’t need to be removed. These will dissolve completely when the area is healed. You may be given antibiotics to help prevent wound infection. You will have a dressing covering your wound, which may be left undisturbed for the first few days.

It is important to let your nurse or doctor know straight away if your wound becomes hot, painful or begins to bleed or leak any fluids, even after you go home.

The days slowly and surely get better, as various tubes and bags are removed and, eventually, you become more mobile and start walking with the physios.

Colin


Pain control (analgesia)

After your operation, you’ll need painkilling drugs for a few days.

To begin with, you may have an epidural anaesthesia. This is given into the space around the spinal cord to numb the nerves in the part of your body where the surgery is carried out.

If you are having an epidural, before the operation an anaesthetist will put a fine tube into your back close to the spinal cord nerves. The tube is attached to a syringe in an electronic pump. The pump gives you a continuous infusion of medicines to numb your nerves and control pain.

Because the tube is very fine, you can still lie on your back when you have an epidural in place. You are also able to sit up and walk around while having this type of pain control.

Some people are given painkilling drugs into a vein (intravenously). These can be given continuously through an electronic pump.

You may have a hand control with a button you can press to give you a boost of painkilling medicine if you feel sore. This is called patient controlled analgesia (PCA). This is designed so that you can’t have too much painkiller (an overdose), so it’s okay to press it whenever you are sore.

It is important to let your doctor or nurse know if you are in pain so that the dose can be increased, or the painkillers changed, as soon as possible. When you are ready to go home, you’ll be given a prescription of painkiller tablets to take as needed at home.

Pain can usually be well controlled with painkillers.


Immediate complications of surgery

This will depend on the type of operation you have. The most common complications after surgery are a wound infection, bleeding in the operation area, a chest infection or developing a blood clot.

The nurses will monitor you for these complications. Let them know straight away if you have any bleeding, feel unwell, have symptoms of an infection such as a cough or discharge from your wound, or swelling and redness in a limb.


Insulin and enzyme replacement

If you’ve had a part of your pancreas removed, the remaining pancreas may not make enough insulin to control your blood sugar just after the operation. You may need to have insulin injections. This is usually only until the remaining pancreas recovers and starts to make insulin again.

If you have an operation to remove your entire pancreas, you’ll need to continue with daily insulin injections. These are given under the skin (subcutaneously). If you already have diabetes, you may have to increase your insulin or tablet dose. A diabetes nurse specialist will give you support and advice about insulin replacement.

You may also need to take capsules containing the digestive enzymes (pancreatin) normally made by the pancreas. Digestive enzymes help your body to break down and absorb fats and protein. If you don’t have enough of them, you may have diarrhoea or your stools (poo) may float, look pale and smell bad. You will also find it difficult to put on weight because you can’t absorb nutrients from your food.

Back to Surgery explained

Surgery for pancreatic cancer

Some people with early-stage pancreatic cancer have surgery to remove the cancer. Some people have surgery to relieve symptoms.

Who might I meet?

A team of specialists will plan your surgery. This will include a surgeon who specialises in your type of cancer.