Surgery to relieve symptoms of advanced pancreatic cancer

If the tumour is pressing on the common bile duct, it can cause a blockage and prevent bile from passing into the bowel. Bile builds up in the blood, causing symptoms of jaundice, such as yellowing of the skin and whites of the eyes; itchy skin; reduced appetite, poor digestion and weight loss; dark urine; and pale stools (poo).

If cancer blocks the duodenum (first part of the small bowel), food cannot pass into the bowel and builds up in your stomach, causing nausea and vomiting.

Blockages of the common bile duct or duodenum are known as obstructions. Surgical options for managing these may include:

stenting – inserting a small tube into the bile duct or duodenum (this is the most common method)
double bypass surgery – connecting the small bowel to the bile duct or gall bladder to redirect the bile around the blockage, and connecting a part of the bowel to the stomach to bypass the duodenum so the stomach can empty properly
gastroenterostomy – connecting the stomach to the jejunum (middle section of the small bowel)
venting gastrostomy – connecting the stomach to an artificial opening on the abdomen so waste can be collected in a small bag on the outside the body.

Sometimes a surgeon may have planned to remove a pancreatic tumour during an operation but discovers the cancer has spread. If the tumour cannot be removed, the surgeon may perform one of the operations listed above to relieve symptoms.

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This information was last reviewed in February 2020. View who reviewed this content.

Dr Lorraine Chantrill, Head of Department, Medical Oncology, Illawarra Shoalhaven Local Health District, NSW; Marion Bamblett, Nurse Unit Manager, Cancer Centre, Fiona Stanley Hospital, WA; Prof Katherine Clark, Clinical Director of Palliative Care, Northern Sydney Local Health District Cancer and Palliative Care Network, and Conjoint Professor, Northern Clinical School, The University of Sydney, NSW; Lynda Dunstone, Consumer; Kate Graham, Accredited Practising Dietitian – Upper GI Dietitian, Peter MacCallum Cancer Centre, VIC; Dr Gina Hesselberg, Radiation Oncologist, St George Hospital Cancer Centre, NSW; Dr Marni Nenke, Endocrinologist and Mary Overton Early Career Research Fellow, Royal Adelaide Hospital, SA; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA; A/Prof Nicholas O’Rourke, Head of Hepatobiliary Surgery, Royal Brisbane Hospital and The University of Queensland, QLD; Rose Rocca, Senior Clinical Dietitian – Upper GI, Peter MacCallum Cancer Centre, VIC; Gail Smith, Consumer. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.

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