Pancreas Surgery

Surgery is the only treatment that offers the possibility of cure for most pancreatic cancers, and it is also used for a number of other conditions:

• Pancreatic cancer (pancreatic ductal adenocarcinoma)
• Pancreatic cysts, including intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms that carry a risk of becoming cancerous
• Neuroendocrine tumours of the pancreas
• Tumours of the bile duct, ampulla and duodenum that involve the head of the pancreas
• Selected complications of chronic pancreatitis

Not every pancreatic lesion needs an operation. Many cysts can be safely monitored with regular scans, and your surgeon will discuss whether surveillance or surgery is the right approach for you.

A Whipple's procedure is used for tumours in the head of the pancreas, the lower bile duct, the ampulla or the duodenum. The head of the pancreas is removed together with the duodenum (the first part of the small bowel), the gallbladder and the lower part of the bile duct. The remaining pancreas, bile duct and stomach are then reconnected to the small bowel so that digestion can continue.

This is a major operation that usually takes several hours and is performed under general anaesthesia. Most patients spend one to two weeks in hospital. It is performed at Westmead Private Hospital and Westmead Hospital with the support of specialist anaesthetic, intensive care and allied health teams.

A distal pancreatectomy removes the body and tail of the pancreas, and frequently the spleen, which shares its blood supply. It is used for tumours and cysts in the left side of the pancreas.

Many distal pancreatectomies can be performed using minimally invasive (laparoscopic or keyhole) techniques, which are associated with smaller wounds, less pain and a shorter hospital stay. If the spleen is removed, you will be offered vaccinations to help protect against infection.

Pancreatic tumours are discussed at a multidisciplinary team (MDT) meeting that includes surgeons, medical oncologists, radiation oncologists, radiologists, gastroenterologists and pathologists. Chemotherapy is often recommended before surgery (neoadjuvant) to shrink the tumour, or after surgery (adjuvant) to reduce the risk of the cancer returning.

At Sydney Surgical Oncology your surgical and medical oncology care is coordinated within one team, so appointments, scans and treatment decisions are aligned from the outset.

Recovery from pancreas surgery takes time. Most people need six to eight weeks before they feel back to normal. During this period you will be seen regularly to check your wounds, weight and nutrition.

Some patients need pancreatic enzyme supplements to help digest food, and a small number develop diabetes or find existing diabetes harder to control. Your team, including a dietitian, will support you through these changes and arrange ongoing surveillance scans and blood tests.