What are the types of surgery?
If you have early-stage pancreatic cancer, you may have an operation to remove it. This is called a resection.
A resection is a major operation. It is only suitable for people with early-stage pancreatic cancer who are fit enough to cope with a major operation. In some people surgery may cure the cancer.
Occasionally, it may be possible to remove a cancer that has spread to nearby blood vessels. You usually have chemotherapy first to try and shrink the cancer.
Only specialist surgeons who have experience in pancreatic surgery will do this type of surgery. You may be referred to a specialist centre for your operation.
It is important to discuss the benefits and risks with your surgeon before you decide to have surgery.
The surgeon may remove all or part of the pancreas during the operation. This will depend on where the cancer is and how much of the pancreas it involves. You may have one of the operations described below.
We have separate information about:
- Having an operation for pancreatic cancer.
- Surgery to relieve symptoms if the cancer is blocking the bile duct or the bowel.
- Treatment for pancreatic cancer.
Pylorus-preserving pancreato-duodenectomy (PPPD)
In this operation, the surgeon removes:
- the head of the pancreas
- most of the first part of the small bowel (duodenum)
- the common bile duct
- the gall bladder
- the surrounding lymph nodes.
It is also called a modified Whipple’s operation. A PPPD is commonly used for people with cancer in the head of the pancreas.
Pancreato-duodenectomy
This is similar to a PPPD operation (above). But the surgeon will also remove the lower part of the stomach. It is also called a Whipple’s operation.
The sections in white are parts removed during a Whipple’s operation.
The surgeon attaches the remaining parts of the stomach, the remaining bile duct and the tail of the pancreas to the small bowel.
Distal pancreatectomy
Total pancreatectomy
Your surgeon will remove the whole pancreas. They will also remove:
- the first part of the small bowel (duodenum)
- part of the stomach
- the spleen
- the gallbladder
- part of the bile duct
- some lymph nodes.
This is a major operation and is rarely used.
Keyhole (laparoscopic) surgery
A small number of hospitals do keyhole surgery using robotic equipment. The camera on the end of the laparoscope gives a three-dimensional magnified view of the inside of the body. This is shown on a video screen to help guide the surgeon. The surgeon controls instruments attached to the robotic equipment.
The main advantage of keyhole surgery is that it leaves a small wound. This means you usually recover quicker. This operation is not available in many hospitals and is not suitable for everyone.
Only surgeons who specialise in both pancreatic cancer and laparoscopic procedures can do keyhole surgery.
About our information
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References
Below is a sample of the sources used in our pancreatic cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
British Society of Gastroenterology. Guidelines for the management of patients with pancreatic cancer peri-ampullary and ampullary carcinomas. 2005.
European Society for Medial Oncology. Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2015. 26 (Supplement 5): v56 to v68.
Fernandez-del Castillo. Clinical manifestations, diagnosis, and staging of exocrine pancreatic cancer. UpToDate online. Jan 2018.
Fernandez-del Castillo C, et al. Supportive care of the patient with locally advanced or metastatic exocrine pancreatic cancer. UpToDate online. Feb 2017.
Winter JM, et al. Cancer of the pancreas, DeVita Hellman and Rosenberg’s Cancer: Principles and Practice of Oncology (10th edition). Lippincott Williams and Wilkins. 2016.
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.