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What is bypass surgery and when is it used for pancreatic cancer?

If your pancreatic cancer is blocking your bile duct or duodenum, bypass surgery may be another way to treat the symptoms of jaundice or being sick.

Bypass surgery won’t remove the pancreatic cancer but it may help your symptoms. Whether this is an option for you will depend on your symptoms, your diagnosis and how fit you are.

  • You may have bypass surgery for a blocked bile duct or duodenum if your surgeon started surgery to remove the cancer (such as a Whipple’s operation), but found that this wasn’t possible because the cancer had spread. Bypass surgery may be done instead to help treat your symptoms.
  • You may have bypass surgery for a blocked duodenum if your cancer can’t be removed by surgery. Your doctor should consider bypass surgery rather than a duodenal stent if you are having longer-term treatment. 
  • If you have cancer that can’t be removed by surgery and your bile duct is blocked, you will usually have a stent put in rather than bypass surgery.

The operation to bypass a blocked bile duct is called a choledochojejunostomy or hepaticojejunostomy. The operation to bypass a blocked duodenum is called a gastrojejunostomy. These operations may be done at the same time to treat both blockages.

Advantages and disadvantages of bypass surgery

Bypass surgery is a big operation, so it’s important to talk to your surgeon about the pros and cons before you decide to have this surgery. Ask them any questions you have.

Advantages

  • The surgery bypasses the blockage and should help your symptoms.
  • It may be an option if a stent is not suitable for you.
  • Bypass surgery avoids the problem of stents getting blocked.
  • It is a longer lasting way to treat your symptoms.

Disadvantages

  • You may have some side effects, but there are usually ways to manage these.
  • You may need to stay in hospital for a few days after bypass surgery, and it may take a few months to fully recover.
  • Problems after surgery are more likely than with stents.

Bypass surgery for pancreatic cancer is major surgery, and as with any major surgery, there are possible risks.

  • There is a risk of your wound getting infected – you will be given antibiotics when you have your surgery to reduce this risk.
  • With all surgery there is a risk that you may have some bleeding during the operation and need a blood transfusion to replace the blood lost. This is not very common and will be done during the operation.
  • There are risks to having a general anaesthetic (medicines that put you to sleep so you don’t feel pain during surgery). These include blood clots in a vein (deep vein thrombosis or DVT) or an allergic reaction to the anaesthetic. But these are very rare.
  • There is a small risk of dying from the surgery.

You can ask our specialist nurses on our free Support Line any questions about bypass surgery.

Updated February 2019

Review date February 2021

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