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Types of Surgery for Pancreatic Cancer

There are several types of surgery for pancreatic cancer. The type of surgery you need depends on the location of the tumor in the pancreas and whether all of the cancer can be removed. These are the main types listed from most to least common.

Whipple procedure (also called pancreaticoduodenectomy)

This surgery is the most common for completely removing tumors from the pancreas. For it, the surgeon removes:

  • The head of the pancreas, which is the wide end

  • Lymph nodes near the bile duct

  • Duodenum, which is part of the small intestine

  • Part of the stomach

  • In some cases, the body of the pancreas, which is the middle section

  • The gallbladder and part of the common bile duct

After this surgery, bile from your liver, food from your stomach, and digestive juices from the remaining part of your pancreas all enter your small intestine so you can have normal digestion.

Pylorus-preserving pancreaticoduodenectomy

This surgery is similar to the Whipple procedure. However, the surgeon does not remove your stomach.

resection
Pylorus-preserving pancreaticoduodenectomy: Anatomy of the resected area (a) and reconnected digestive tract with end-to-end pancreaticojejunostomy (b).

Total pancreatectomy

This surgery is done less often than the Whipple procedure. For this, the surgeon removes your:

  • Entire pancreas

  • Distal common bile duct

  • Duodenum, which is part of the small intestine

  • Spleen

  • Gallbladder, if you still have one

Once your entire pancreas is taken out, you won’t be able to make pancreatic juices or insulin. You will need to test your blood glucose levels, give yourself insulin injections, and take other steps to keep your blood glucose levels normal. You will also need to take pancreatic enzyme pills with food to aid in digestion.

Distal pancreatectomy

For this surgery, the surgeon removes only the tail of the pancreas, which is the thin part, and perhaps part of its body, the middle section. The surgeon also usually takes out your spleen.

Palliative procedures

Your doctor may suggest surgery and other procedures to ease or prevent symptoms associated with pancreatic cancer. These procedures may help restore your bile flow, allow food to leave your stomach into your small intestine, or ease pain. For instance, surgery may relieve a blocked bile duct by bypassing it. Surgery may also relieve a blockage at the outlet of the stomach to the small intestine (called the duodenum) by bypassing it. This is called bowel-bypass surgery. It doesn’t cure the disease. These are some of the types of palliative surgery:

  • Surgery to redirect the flow of bile directly into your small intestine

  • Surgery to allow your stomach to empty into another portion of your small intestine

  • Injections to block or numb nerves near your pancreas

Online Medical Reviewer: Bass, Pat F. III, MD, MPH
Online Medical Reviewer: Foster, Sara RN, MPH
Last Annual Review Date: 4/19/2011
© 2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.
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