Surgery to remove the cancer

Surgical removal (resection) of the tumour is the most common treatment for people with early-stage cancer who are in good health. It may also be considered for some stage 3 cancers, usually with chemotherapy (and sometimes radiation therapy) to shrink the tumour first. These stage 3 cancers are known as borderline resectable cancers, which means that surgery might be able to remove them.

Learn more about:

• Types of surgery
• How the surgery is done
• If the cancer has spread
• Having a Whipple procedure

Types of surgery

The aim of resection 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.

Types of surgery include:

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.

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 so the surgeon can remove the cancer.
• Laparoscopic surgery involves a number of small cuts in the abdomen. It is sometimes known as keyhole or minimally invasive surgery. The surgeon inserts a long, thin instrument with a light and camera (laparoscope) into one of the cuts and uses images from the camera for guidance. The surgeon inserts tools into the other cuts to remove the cancer.
• Robotic-assisted surgery is a type of minimally invasive surgery. The surgeon sits at a control panel to see a three-dimensional image and moves robotic arms that hold the instruments.

Open surgery is usually the best approach for pancreatic cancer, but laparoscopic or robotic-assisted surgery may be offered as an option in some circumstances.

Talk to your surgeon about what options are available to you, ask about the risks and benefits of each approach, and check if there are any extra costs.

For more on this, see our general section on Surgery.

If the cancer has spread

During surgery to remove the cancer, the surgeon may find that the cancer has spread around one or more of the major blood vessels in the area or into the lining of the abdomen (peritoneum). This may occur even if you had several scans and tests beforehand.

If this happens, the surgeon will not be able to remove the cancer. However, they may be able to perform procedures (such as a bypass) that will relieve some of the symptoms caused by the cancer.

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