The surgeries for pancreatic cancers depend on the location of the tumor in the pancreas.
Majority of the pancreas cancer however are in the head region of the pancreas and the operation performed is “Whipple’s surgery”.
“Distal Pancreatectomy” is performed for tumors located in the tail or body portion of the pancreas and the surgery involves removal of the body and tail portion of the pancreas along with the spleen.
This major operation involves removal of:
- part of the pancreas
- part of the first part of the small bowel (duodenum)
- part of the stomach
- part of the gall bladder and part of the bile duct.
The diagram below shows what your surgeon removes
The surgeon reconnects the remainder of the pancreas, bile duct and stomach to different sections of the small bowel so the digestive tract keeps working.
A feeding tube may be placed during the surgery to replenish nutrition to the patient after surgery.
This operation is performed for certain types of pancreatic tumors located in the tail or body portion of the pancreas. This surgery involves removal of only the tail of the pancreas or the tail and a portion of the body of the pancreas. The spleen is usually removed as well.
Sometimes surgery may begin with the hope it will cure the patient, but the surgeon discovers this is not possible. In this case, the surgeon may continue the operation as a palliative / bypass procedure to relieve or prevent symptoms.
Cancers growing in the head of the pancreas can block the common bile duct as it passes through this part of the pancreas. This may cause pain and digestive problems because the bile can’t get into the intestine and patient develops jaundice and vomiting. The bile chemicals will build up in the body
There are 2 options for relieving bile duct blockage.
Surgery can be done to reroute the flow of bile from the common bile duct directly into the small intestine, bypassing the pancreas. Sometimes, the stomach connection to the duodenum (the first part of the small intestine) is rerouted at this time as well. Often, late in the course of pancreatic cancer, the duodenum becomes blocked by cancer, which can cause pain and vomiting that requires surgery. Bypassing the duodenum before this happens can help avoid a second operation.
A second approach to relieving a blocked bile duct does not involve surgery. Instead, a stent (small tube) is placed in the duct to keep it open. This is usually done through an endoscope (a long, flexible tube) while the patient is sedated. The doctor passes the endoscope down the patient’s throat and all the way into the small intestine. The doctor can then insert the stent into the bile duct through the endoscope. The stent helps keep the bile duct open and resists compression from the surrounding cancer.