Before your operation for pancreatic cancer

You might go into hospital on the morning of your operation or the day before. The length of your hospital stay depends on what operation you have. You are usually in hospital for around 10 to 14 days after surgery. Some hospitals have an enhanced recovery programme where they aim to have most people home within 7 days of surgery.

Tests to check you are fit for surgery

You have tests before your operation to check:

• your fitness for an anaesthetic, if you need one

• that you’ll make a good recovery from surgery

You might have some or all of the following tests:

• blood tests to check your general health and how well your kidneys are working

• a swab test to rule out some infections

• an ECG to check that your heart is healthy

• breathing tests (called lung function tests)

• an echocardiogram (a painless test of your heart using sound waves)

• a chest x-ray to check that your lungs are healthy

You might not need all of these tests if you had them when you were diagnosed.

Tumour markers

Tumour markers are substances that might be raised if there is a cancer. They’re usually proteins. They can be found in the blood, urine or body tissues. 

Some tumour markers are only produced by one type of cancer. Others can be made by several types. Some markers are found in non cancerous conditions as well as cancer.

Doctors might use tumour markers to monitor how well your cancer treatment is working or check if the cancer has come back. 

If you have pancreatic cancer your doctor might test for cancer antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA).

Removing the spleen

If you are having your ​spleen​ removed as part of your operation, you will have vaccinations before or after surgery. The spleen helps you fight infection. So without a spleen you have a weakened immune system and are more likely to get infections.

Vitamin K

If you have been finding it difficult to digest fats, you may have low levels of vitamin K. Vitamin K helps the blood to clot, so your vitamin K levels might need to be corrected before your surgery. This can be done by taking vitamin K tablets, having injections, or through a drip into your bloodstream.

Pre assessment clinic

Your pre assessment clinic appointment prepares you for your operation. You have it about a week or so before surgery.

You meet members of your treatment team at this appointment. You might also sign the consent form to agree to the operation.

Your doctor or nurse might talk to you about the Enhanced Recovery Programme at your hospital. This is a programme of care that helps people recover more quickly after a big operation.

Ask lots of questions during your appointment. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.

You can ask more questions when you go into hospital. So don’t worry if you forget to ask, or think of more questions when you get home.

Who you might meet before your operation

Nurse or healthcare assistant 

At the pre assessment clinic a nurse or health care assistant checks your:

• general health

• weight

• blood pressure

• pulse

• temperature

The nurse asks you questions to check your fitness for the operation. They can organise any further tests you might need. They ask about any medicines you are taking (such as blood thinners), and if you have diabetes or other medical conditions. They give you information about what to expect when you come into hospital for the operation.

Specialist nurses

You may see a nurse who specialises in surgery of the bile ducts, liver and pancreas. They can help answer any questions you have about the operation.

You may also see your specialist cancer nurse. They can check what help and support you have to see what you will need when you go home. They are usually your main point of contact, and care for you after your operation for the rest of your treatment.

The anaesthetist

The anaesthetist gives you the general anaesthetic and looks after you during the operation. They make sure you’re fit enough for the surgery.

The surgeon

A member of the surgical team will tell you about:

• the operation you are going to have

• the benefits of having surgery

• the possible risks

• what to expect afterwards

The dietitian

The dietitian gives you help and advice about managing your diet. They:

• help you get as well as possible before your operation

• explain how the surgery affects your diet

• give useful tips on how to increase your nutrients and calories

They can also advise about managing diabetes and the enzyme supplements you might need to take after the operation.

They might give you nutritional supplement drinks to have before surgery.

The physiotherapist

The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.

The physios or nurses also teach you leg and breathing exercises to do after your operation to help with recovery. Learning how to do the exercises beforehand makes it easier afterwards.

Learning breathing and leg exercises

Breathing exercises help to stop you from getting a chest infection after surgery. If you smoke, it helps if you can stop at least a few weeks before your operation.

Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin.

You start the injections after your operation. You might also wear anti embolism stockings or have pumps on your calves to help the circulation.

Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.

This 3-minute video shows you how to do the breathing and leg exercises.

Going into hospital

You might go into hospital the evening before or the morning of your surgery.

Your nurse might give you a carbohydrate-rich drink to have the evening before the operation. You might also have it the following morning. The drink gives you energy and can speed up your recovery.

When you're in hospital your nurse will check your:

• blood pressure

• pulse

• temperature

• breathing rate

You might have fluids through a drip (intravenous infusion) into your arm. This is usually if you have been finding it difficult to drink.

What to take with you

Take in:

• nightgowns or pyjamas

• underwear

• dressing gown

• slippers

• contact lenses, solution, glasses and a case

• wash bag with soap, a flannel or sponge, toothbrush and toothpaste etc

• sanitary wear or tampons

• towel

• small amount of money

• medicines you normally take

• magazines, books, playing cards

• headphones and music to listen to

• a tablet or smartphone for web browsing, entertainment and phone calls

• chargers for electronic devices

• a copy of your last clinic letter (if you have one)

Family and friends

Before you go into hospital, it might be worth checking:

• whether the ward is allowing visitors

• if they have set visiting times

• the best number for friends and family to phone, to find out how you are

The letter you receive before your operation may contain this information. But if not, you can phone the ward or hospital reception to find out.

You can use your mobile phone in hospital. But there may be some time before and after your operation when you won’t have your mobile nearby. And you may not feel like talking.

Before you go into hospital

It’s worth sorting out a few things before you go into hospital. These might include:

• taking time off work

• care for children or other loved ones

• care for your pets

• care for your house

• cancelling your milk, newspapers or food deliveries

Go to information about on the day of your surgery