Which surgery for pancreatic cancer?

This page has basic information on operations for cancer of the pancreas. There is information on

A quick guide to what's on this page
Removing pancreatic cancer completely
Relieving symptoms of pancreatic cancer

Which surgery for pancreatic cancer?

Your surgeon will look at your pre-op tests to decide whether it is possible to remove your pancreatic tumour. Your scans may show the size and position of the tumour. A tumour that is less than 3cm across is most likely to be removable.

Removing the tumour completely

If it is possible to remove your cancer, your surgeon may suggest a Kausch-Whipple operation (usually called a Whipple's operation). This means removing part of your pancreas, the duodenum, part of the stomach and your gallbladder. Or your surgeon may suggest other operations to remove part, or all, of your pancreas.

Operations to relieve symptoms

You can have an operation to relieve jaundice or relieve a bowel obstruction. Jaundice happens when the bile duct is blocked. It is not unusual for a pancreatic cancer to block the bile duct by pressing on it or growing over it. Your surgeon can relieve your jaundice by putting in a stent or bypassing the bile duct.

If your cancer is blocking the top of your small bowel then your surgeon may be able to bypass the blockage, and construct another route for the food passing through your digestive system.

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To find out whether this is possible for you, your surgeon will look at

The size of the tumour
Where it is in the pancreas
Whether the cancer has grown into the tissues around the pancreas
Whether the cancer is in any of the lymph nodes around the pancreas
Whether the cancer has grown into the major blood vessels in or around the pancreas
Whether the cancer has spread to any other parts of the body

Your surgeon can find the answers to some of these questions from your pre-op tests. Your scans may show the size and position of the tumour. A tumour that is less than 3cm across is most likely to be removable. And cancers in the head of the pancreas are often easier to remove than cancers in the body or tail of the pancreas. This is because they tend to be diagnosed at an earlier stage.

Scans may also show up cancer spread to other parts of the body. But it may be necessary for your surgeon to try the operation without knowing exactly whether the cancer has spread to lymph nodes or invaded blood vessels.

If it is possible to remove your cancer your surgeon may suggest

Kausch-Whipple operation (usually called a Whipple's operation)
Total pancreatectomy
Distal pancreatectomy

A Kausch-Whipple operation means removing part of your pancreas, the duodenum, part of the stomach and your gallbladder. There is a variation called a pylorus preserving Kausch-Whipple operation, which is the same, except none of your stomach is removed. There is more about all these operations in the section surgery to try to cure pancreatic cancer.

You can have an operation for these symptoms of pancreatic cancer

Jaundice
Bowel obstruction

Jaundice

Jaundice happens when the bile duct is blocked. The opening of the bile duct is right next to the opening of the pancreatic duct. So it is not unusual for a pancreatic cancer to block the bile duct by pressing on it or growing over it. Your surgeon can relieve your jaundice by

There is more about these operations in the CancerHelp UK section surgery to relieve symptoms.

Bowel obstruction

If your cancer is blocking the top of your small bowel (the duodenum) your surgeon may be able to bypass the blockage and construct another route for the food passing through your digestive system. There is more about this operation in the CancerHelp UK section surgery to relieve symptoms.