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Types of surgery

Get information about the difference between surgery to remove pancreatic cancer and surgery to relieve symptoms.

How a decision is made

To find out if it might be possible to remove the cancer, your surgeon will look at:

  • the size of the tumour
  • where it is in the pancreas
  • whether the cancer has grown into the tissues around the pancreas
  • whether the cancer is in any of the lymph nodes around the pancreas
  • whether the cancer has grown into the major blood vessels in or around the pancreas
  • whether the cancer has spread to any other parts of the body

Using scans

Your scans might show the size and position of the tumour. A tumour less than 3cm across is likely to be removable.

Surgeons are more likely to be able to remove cancers in the head of the pancreas than in the body or tail of the pancreas. This is because they tend to be diagnosed at an earlier stage.

Scans might show cancer spread to other parts of the body. In some cases, your surgeon may still advise you to have surgery even if there is a suspicion the cancer might have spread to the nearby lymph nodes or major blood vessels.

Different types of surgery

If it is possible to remove your cancer your surgeon might suggest a:

Total pancreatectomy

Your surgeon removes all your pancreas.

Distal pancreatectomy

Your surgeon removes the body and tail of your pancreas.

Pylorus preserving pancreaticduodenectomy (PPPD)

A PPPD operation means removing:

  • the head of your pancreas
  • the duodenum - the first part of the small bowel (intestine)
  • gallbladder
  • part of the bile duct
What and where the pancreas is

Kausch Whipple operation

This is usually called a Whipple's operation. It's the same as a PPPD operation but you also have part of your stomach removed.

Relieving symptoms

The opening of the bile duct is right next to the opening of the pancreatic duct. So it is not unusual for pancreatic cancer to block the bile duct by pressing on it or growing over it.

You might have an operation to relieve symptoms such as jaundice and sickness caused by a blockage in the bile duct.

You might be very sick if the cancer is blocking the very top of your small bowel (duodenum). This is because the blockage stops food passing into the bowel. Your surgeon might do an operation to bypass any blockages.

Tubes to help with symptoms

Instead of surgery, you are now more likely to have a tube (stent) put in to keep the bile duct or duodenum open to help relieve symptoms.

Last reviewed: 
30 Jun 2017
  • Cancer of the Pancreas: European Society Medical Oncology Clinical Practice Guidelines
    M. Ducreux and others
    Annals of Oncology, 2015

    Volume 26, Supplement 5

  • Pancreatic adenocarcinoma
    G Bond-Smith and others
    British Medical Journal, 2012

    Volume 344

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