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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