Surgery for pancreatic cancer

Some people who have early-stage pancreatic cancer have an operation to remove it (a resection). All or part of the pancreas may be removed, depending on where the cancer is and how much of the pancreas is involved.

One of the following operations may be done:

  • A pylorus-preserving pancreatoduodenectomy (PPPD), also called a modified Whipple’s operation. This involves removing the head of the pancreas, most of the duodenum, the common bile duct, gall bladder and the surrounding lymph nodes.
  • A pancreatoduodenectomy or Whipple’s operation. This is similar to the PPPD, but the lower part of the stomach is also removed.
  • A distal pancreatectomy (removal of the lower end of the pancreas).
  • A total pancreatectomy (removal of the whole pancreas).

In some specialist centres, the surgeon may carry out laparoscopic (keyhole) surgery for a distal pancreatectomy. Instead of one large cut (incision), you have several small cuts.

Surgery may also be done to relieve symptoms if pancreatic cancer blocks the bile duct or the bowel.

Surgery for cancer of the pancreas


Surgery to remove the cancer

Surgery to remove the cancer

Sometimes, it is possible to remove all of the cancer with surgery. This is a major operation. It is only suitable for people with early-stage pancreatic cancer. In some people, it may cure the cancer.

Only specialist surgeons who have experience in pancreatic surgery will do this type of operation. You may be referred to a specialist centre for it.

It is important to discuss the benefits and risks with your surgeon before deciding 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.

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. But the surgeon will also remove the lower part of the stomach. It is also called a Whipple’s operation.

A Whipple’s operation
A Whipple’s operation

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The sections in white are the parts removed during a Whipple’s operation.

 After a Whipple's operation
After a Whipple's operation

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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

This involves removing the lower end (body and tail) of the pancreas. The spleen is often removed at the same time. This is because it is close to the tail of the pancreas. The spleen is part of the lymphatic system.

Total pancreatectomy

Your surgeon will remove the whole pancreas. They will also remove:

  • the duodenum
  • part of the stomach
  • the spleen
  • the gallbladder
  • part of the bile duct
  • some lymph nodes.

This is a major operation and is rare.

I had a Whipple’s procedure to remove my gall bladder and parts of my pancreas. Within a couple of days, I was marching on the spot and shuffling down corridors.

Carole


Keyhole (laparoscopic) surgery

In some specialist centres, the surgeon may do keyhole (laparoscopic) surgery. This can be used for a distal pancreatectomy (see above). Instead of one large cut (incision), the surgeon will make several small cuts. They use a special instrument called a laparoscope to see into and work inside the tummy (abdomen).

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.

Back to Surgery

Who might I meet?

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

What happens after surgery?

You’ll be monitored closely after your operation. How quickly you recover will depend on the surgery you’ve had.