All operations to remove pancreatic cancer are major surgery and take place in specialist centres.
As with any operation, there is a risk of complications. A complication is anything that happens after surgery that makes your recovery more difficult. For example, chest infections and blood clots are possible complications after any surgery.
Before offering surgery to you, your doctors make sure the benefit of having the operation outweighs the possible risks.
Your doctors will talk to you about the possible complications of the surgery and
Some complications can be serious. But they are becoming less common as surgery is done at specialist centres where the surgeons do more of these operations.
Some of the possible problems after having surgery to remove pancreatic cancer include:
Internal infection or abcess and fluid collection
If fluid collects internally around the operation site, it may become infected. Sometimes this is a sign of a problem with the internal joins after surgery.
You have antibiotics through your drip if you develop an internal infection.
Your doctor may need to drain any abscesses or fluid that has collected internally. They usually do this by using x-ray or ultrasound to help guide a needle or tube into place.
An abnormal opening (fistula)
The word fistula means opening. This could be a pancreatic fistula or more rarely a biliary fistula.
The cause is usually because part of the internal stitching has come apart or broken down. For pancreatic fistulas it means that some of the digestive juices are able to get into your tummy (abdomen). And for biliary fistulas,
Around 1 in 10 patients (10%) having major pancreatic surgery will have a pancreatic fistula.
If you get one, you will have a wound drain put in and have drugs to control the inflammation. The drains will be left in until the fistula dries up. The fistula then heals on its own. Sometimes, the surgeon has to operate again to repair the leak.
You may have bleeding straight after your operation. This could be because a blood vessel tie is leaking or because your blood is not clotting properly.
Bleeding in the few days following surgery can happen because there is infection or a fistula forming. How bleeding is treated depends on what is causing it. Some people may need a blood transfusion.
Blood clots (deep vein thrombosis, DVT) are a possible complication of having surgery as you are not moving about as much. DVTs can block the normal flow of blood through the veins. There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs, causing a blockage (pulmonary embolism). Most blood clots can be successfully treated and steps are taken in hospital to reduce the risk of a clot developing in the first place.
A chest infection is a common complication of many operations. It happens because you are not moving around or breathing deeply enough after your surgery. What you would normally cough up stays in your lungs and becomes a focus for infection. You can help to prevent this by doing your deep breathing exercises.
Your physiotherapists and nurses will get you up as soon as possible to help you get moving.
Below is a short video showing breathing and circulation exercises after surgery. Click on the arrow to watch it.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a hu. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
You will have had heart tests before your surgery, but these are very big operations and do increase the strain on your heart. Some people develop heart problems after surgery that they did not have before.