Surgery for early pancreatic cancer

Surgical removal (resection) of the tumour is the most common treatment for people with early-stage disease who are in good health. Before the surgery, your treatment team may recommend that you have chemotherapy, with or without radiation therapy, to shrink the tumour.

The aim of surgery for early pancreatic cancer is to remove all the tumour from the pancreas, as well as a margin of healthy tissue. The type of surgery you have will depend on the size and location of the tumour, your general health and your preferences. Your surgeon will talk to you about the most appropriate surgery for you, as well as the risks and any possible complications.

Learn more about:

• Types of surgery
  • Whipple procedure 
  • Distal pancreatectomy  
  • Total pancreatectomy 
• How the surgery is done
• Surgery to relieve symptoms
• Having a Whipple procedure

Types of surgery

Whipple procedure

This treats tumours in the head of the pancreas. Also known as pancreaticoduodenectomy, it is the most common surgery for pancreatic tumours. Learn more about this operation.

Distal pancreatectomy

The surgeon removes 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. The spleen helps the body fight infections, so if it is removed you are at higher risk of some types of bacterial infection. Your doctor may recommend vaccinations before and after a distal pancreatectomy.

Total pancreatectomy

When cancer is large or there are many tumours, the entire pancreas and spleen may be removed, along with the gall bladder, common bile duct, part of the stomach and small bowel, and nearby lymph nodes. It is possible to live without a pancreas. As the body will no longer produce insulin, you will have insulin-dependent diabetes and need regular insulin injections. You will also need to take pancreatic enzyme supplements to help digest certain foods. It is important that an endocrinologist is part of your treatment team. They can help you adapt to life without a pancreas.

How the surgery is done

Surgery for pancreatic cancer is carried out in hospital under a general anaesthetic. There are three main approaches:

• Open surgery involves one larger cut in the abdomen.
• Laparoscopic surgery involves several small cuts in the abdomen. The surgeon inserts a light and camera (laparoscope) into one of the cuts and performs the surgery using images from the camera for guidance.
• Robotic-assisted surgery uses a robotic device to help the surgeon perform laparoscopic surgery.

Compared to open surgery, laparoscopic surgery and robotic-assisted surgery usually mean a shorter hospital stay, less bleeding, a smaller scar and a faster recovery time. However, open surgery may be the best option in some situations. Talk to your surgeon about what options are available to you and check if there are any extra costs.

For more on this, see Surgery.

Surgery to relieve symptoms

During surgery to remove the cancer, the surgeon may find that the cancer has spread (metastasised) into one or more of the major blood vessels in the area. This may occur even if you had several scans and tests beforehand. If this happens, the surgeon will not be able to remove the tumour. However, they may be able to perform procedures (such as a double bypass) that will relieve some of the symptoms caused by the cancer.

See Surgery for advanced pancreatic cancer for more information.