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. They will also encourage you to do regular leg movements and deep breathing exercises.

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

Straight after the operation, you will not be able to eat or drink. You will have fluids through a drip or extra nutrition through a feeding tube. You can usually start drinking small amounts the day after the operation. The wound will be closed with stitches, clips or staples. The stitches are usually removed 10 to 14 days after the operation. Tell your nurse or doctor if you have any problems with your wound, such as pain or heat, or if it begins to bleed (or leak) fluids.

Depending on the operation you have had, you can usually go home 5 to 10 days after surgery. 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. Your recovery time will depend on the type of surgery you have.

Most people receive care in an intensive care or high-dependency unit for a few days after their operation. This is routine and does not mean your operation went badly or had complications. It is also usual in some hospitals for a machine (ventilator) to help you breathe for a few hours. You will probably feel quite drowsy and may not remember much about the first days after your operation.

The nurses will encourage you to start moving about as soon as possible. This is an important part of your recovery. It will help prevent problems such as chest infections or blood clots. The nurses will encourage you to do regular leg movements and deep breathing exercises. A physiotherapist or a nurse can explain these to you.


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 gives you fluids until you can eat and drink again. It can also give you painkillers and other medications.
  • One or more drainage tubes coming from your wound. These drain away fluids, such as blood, bile or pancreatic juices. You will have these drainage tubes until 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 do not feel sick. You may need this for several days.
  • A small flexible tube (catheter). This will drain urine from your bladder into a collecting bag. This means you will not have to get up to pass urine. You will usually only have this for a couple of days.


Pain control

It is normal to have some pain and discomfort after your operation. You can usually control this with painkillers. If you are in pain, tell the nurses. They may need to change the dose or type of painkiller.

You may have a spinal block during the operation. This is an injection of long-lasting painkiller into the fluid around the spinal cord. It gives pain relief for up to 24 hours. Or you may have an epidural. This is a pump that continuously delivers painkiller into the spinal fluid through a fine tube.

Painkillers can also be given through a tube into a vein in your hand or arm (a cannula). The tube connects to a pump. This is called PCA (patient-controlled analgesia). You can give yourself an extra dose of painkiller when you need it by pressing a button. The machine is set so you get a safe dose and cannot have too much.

Before you go home, your pain will be controlled by tablets or patches. You will get a prescription for painkillers you can take at home as needed.


Eating and drinking

Straight after the operation, you will not be able to eat or drink. Until you can, you will have fluids through a drip. Some people have extra nutrition through the drip. Or you may have a feeding tube (NG tube). This is passed through the nose and into the stomach.

You can usually start drinking small amounts of fluid the day after the operation. The surgeon will tell you when you can. You may have supplement drinks for a few days. These will give you the nutrition you need to help your recovery.


Wound care

The surgeon will close the wound with stitches, clips or staples. The stitches are usually removed 10 to 14 days after the operation. Your practice nurse can do this if you have gone home. If you cannot leave home, a district nurse can visit you.

You may have antibiotics to help prevent wound infection. You will have a dressing covering your wound. This may be left undisturbed for the first few days.

It is important to let your nurse or doctor know straight away about any problems with your wound. Tell them if the wound becomes hot or painful, or if it begins to bleed or leak fluids, even after going 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


Going home

Depending on the type of operation, you can probably go home 5 to 10 days after surgery. Your doctor or specialist nurse will be able to give you more information.

You will have an appointment at an outpatient clinic for your post-operative check-up. This lets you discuss any further treatment you may need with them, such as radiotherapy or chemotherapy.


Replacing insulin and digestive juices

Insulin injections

If you have had part of your pancreas removed, your body may struggle to control blood sugar. This is because the remaining pancreas may not be making enough insulin. 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 had an operation to remove your whole pancreas, you will need daily insulin injections. You will need to have these injections for life. These are given under the skin (subcutaneously). You will also need to check your blood sugar level regularly. A diabetes nurse will give you support and advice about insulin replacement. If you already have diabetes, you may have to increase your insulin or tablet dose.

Digestive juices

You may need to replace the digestive juices (enzymes) that the pancreas normally makes. This will depend on the type of operation you have had. Your surgeon or nurse or a dietitian will give you more information.

Digestive enzymes help your body to break down and absorb fats and protein. If you do not have enough of them, you may have diarrhoea. Your stools (poo) may float, look pale and smell bad. You will also find it difficult to put on weight because you cannot absorb nutrients from your food.

You can replace the digestive enzymes by swallowing capsules. You will usually take these every time you eat or have a milky drink. Your nurse or a dietitian will explain how to take the capsules. You will need to take the capsules for the rest of your life.

Commonly used pancreatic enzyme replacement therapy drugs are:

  • Creon®
  • Nutrizym®
  • Pancrease®
  • Pancrax®.

Most replacement enzymes are made from pork. It is also possible to get enzymes from beef. Vegetarian based enzymes are not available. The most commonly used supplement is a tablet called Creon, which is a pork-based enzyme replacement. There is no alternative that is not pork-based. It has been approved for use by Jewish patients by the Chief Rabbi. Previous rulings by Islamic scholars suggest that Muslims may use pork-based medicines if there is no alternative. If you have concerns about this, speak to your religious leader.

Back to Surgery

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.