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Types of surgery

Learn about the difference between surgery to completely remove cancer and surgery to relieve symptoms.

Removing the cancer completely

To find out if it may 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

Your scans may 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 may 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 may have spread to the nearby lymph nodes or major blood vessels.

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

  • pylorus preserving pancreaticduodenectomy (PPPD)
  • Kausch Whipple operation (usually called a Whipple's operation)
  • total pancreatectomy (removing all the pancreas)
  • distal pancreatectomy (removing the body and tail of the pancreas)

A PPPD operation means removing:

  • the head of your pancreas
  • the duodenum
  • gallbladder 
  • part of the bile duct.

The Kausch Whipple operation is the same but you also have part of your stomach removed.

Relieving symptoms

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

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 may 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 may do an operation to bypass any blockages.

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: 
07 Jun 2014
  • Guidelines for the management of patients with pancreatic cancer, periampullary and ampullary carcinomas
    British Society of Gastroenterology (BSG), 2005

  • Pancreatic adenocarcinoma: ESMO-ESDO clinical practice guidelines for diagnosis, treatment and follow up
    T Seufferlein, JB Bachet, E Van Cutsem (and others)
    Annals of Oncology. 2012. 23 (supplement 7):vii33-vii40

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