Types of surgery to remove pancreatic cancer
There are several different operations for pancreatic cancer. They involve removing all or part of the pancreas, and sometimes other areas around it.
Your surgeon will discuss with you the best type of surgery for you. This will depend on where the cancer is in the pancreas.
Whipple’s operation (pancreaticoduodenectomy or PD)
The Whipple’s operation is one of the most common types of surgery for pancreatic cancer. It’s usually used for tumours in the head of the pancreas that haven’t spread beyond the pancreas.
The surgeon will remove the head of the pancreas. They also remove:
- The lower end of the stomach
- The duodenum (first part of the small intestines)
- The gall bladder (which stores a fluid called bile which helps digestion)
- Part of the bile duct (which carries bile from the liver to the duodenum)
- Surrounding lymph nodes (part of the immune system).
They then attach the remaining part of the stomach and bile duct to the small intestines. The pancreas is attached to the small intestines or to the stomach.
This diagram shows the parts of the body to be removed by a Whipple’s operation
This diagram shows the pancreas and surrounding organs after a Whipple’s operation
As part of your pancreas is removed during a Whipple’s operation, your digestion will be affected, and you will probably need to take pancreatic enzyme supplements. There is also a risk of getting diabetes.
Pylorus-preserving pancreaticoduodenectomy (PPPD)
This operation is similar to the Whipple’s operation, but none of the stomach is removed. The stomach valve (the pylorus), which controls the flow of food into the duodenum, isn’t removed either. The tail of the pancreas is joined to the small intestines or stomach.
A distal pancreatectomy involves removing the body and tail of the pancreas. The spleen is also often removed. The spleen helps your body to fight infections, so if it’s removed, you will be more at risk of infections. Usually before surgery you will be given vaccinations against some infections, and you will need to take antibiotics for the rest of your life.
As part of your pancreas is removed, your digestive system may also be affected, and. you may need to take pancreatic enzymes supplements.
You will also have a high risk of getting diabetes, and may need to take medication to manage this.
This diagram shows the parts of the body to be removed by a distal pancreatectomy
This diagram shows the pancreas and areas around it after a distal pancreatectomy
A total pancreatectomy involves removing the whole pancreas, the duodenum, the gall bladder, part of the bile duct and sometimes part of the stomach. Exactly what is removed will depend on where the cancer is located. It is done when there is a large tumour, or more than one tumour in the pancreas.
This diagram shows the parts of the body that will be removed by a total pancreatectomy
This diagram shows the pancreas and areas around it after a total pancreatectomy
Removing part of a vein
Sometimes the cancer grows into or around the major veins that lie next to the head of the pancreas (superior mesenteric and portal veins). To remove the cancer completely, the surgeon may need to remove part of the vein. The vein is then joined back together. This is called vein resection and reconstruction.
This is specialised surgery and might not be available at your nearest specialist centre, so ask your consultant about this. For example, you may be referred to another specialist centre to have the surgery. You can also ask for a second opinion from another surgeon. You will also need to be very fit and well to have this type of surgery.
Questions to ask
- Which type of operation do I need?
- How much of my pancreas will be removed?
- Will any other parts of my body be removed?
- Will I need to take any medication after surgery?
Published February 2017
Review date February 2019