Surgery for Pancreatic Cancer

Evaluation by a surgeon is an important part of treating pancreatic cancer. Not all patients are candidates for surgery, but surgical removal of your tumor can be a potential cure for pancreatic cancer.

Matthew Bower, MD, Surgical Oncology

Your physician team may recommend the surgical removal of all or part of your pancreas. The surgical oncologists at Scott & White are specially trained in this intricate surgery and its after-effects. They’re experts in the field of abdominal surgery, performing hundreds of such highly complex surgeries a year. They have the necessary experience to skillfully care for you. You’re in good hands here.

The team may also recommend other treatments in addition to surgery.

At Scott & White, we use minimally invasive techniques whenever possible and appropriate, based on your condition. However, pancreatic surgery for cancer is complex and in most cases cannot be easily performed with a minimally invasive approach. Some small tumors in the tail of the pancreas can sometimes be removed with the aid of a camera and small incisions.

As with all operations, there are some risks. Your surgeon will discuss those risks with you.

Surgical Procedures

Whipple Procedure (Pancreaticduodenectomy)

This is the most common type of surgery for pancreatic cancer. If your pancreatic cancer is located at the head of your pancreas, your surgical oncologist may perform a Whipple procedure, or the surgical removal of only the head of the pancreas (sparing the remainder of your pancreas). In addition to the head of the pancreas, other tissues are removed, including:

  • Part of your small intestine
  • The lower part of your bile duct
  • Part of your stomach
  • Your gallbladder

Your surgeon will then reconnect your digestive and biliary systems. Tissue samples will be sent to the laboratory for evaluation by a pathologist.

Your GI Cancer Team at Scott & White has the experience necessary to perform this complicated operation.

Distal Pancreatectomy

If your tumor is located in the tail of your pancreas, your surgeon may perform a distal pancreatectomy, or the surgical removal of only the tail and body of the pancreas. Because your spleen and pancreas share a common blood source, your surgeon may also remove your spleen. The head of your pancreas is preserved.

At Scott & White, many of our distal pancreatectomies are performed using minimally invasive techniques. Benefits of minimally invasive surgery include:

  • Less pain
  • Better cosmetic result
  • Shorter hospital stay
  • Less blood loss
  • Lower risk of infection
  • Quicker recovery times

Not all patients are candidates for a minimally invasive approach. Factors affecting the decision to use minimally invasive techniques include:

  • Tumor location or size
  • Patient obesity and health
  • Prior surgeries


If tumors occur throughout your pancreas, your surgeon may perform a total pancreatectomy, or the surgical removal of your entire pancreas.

This surgery also includes the removal of:

  • The first portion of your small intestine
  • Part of your stomach
  • Common bile duct
  • Gallbladder
  • Spleen
  • Lymph nodes

Tissue samples will be sent to the laboratory for evaluation by a pathologist.

Special Note Regarding Pancreatectomies

Operations to remove all or part of your pancreas are highly complex, requiring the expert skill of our experienced surgical oncologists and our GI Cancer Team. You will stay in the hospital a week or more and need a month or more of recovery at home.

As with all operations, there are some risks. With pancreatectomies, you may have additional side effects, including:

• Difficulty digesting food
• Feeling bloated or full
• Nausea and vomiting
• Diabetes from lack of insulin
• Infections
• Bleeding

Your dietitian on your Integrated Care Team will be key in helping you adjust your diet and return to feeling normal again.

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Palliative Measures

Biliary Obstruction

Stent Insertion

If you have a blocked bile duct, your physician may recommend the placement of a small tube (a stent) in your bile duct in order to keep it open. Your gastroenterologist will insert a very small high-definition camera attached to a thin tube (an endoscope) down your throat and into your small intestine. Through the endoscope your physician will insert the stent into your bile duct.

Surgical Bypass

Another option to clear a blocked bile duct is for your surgeon to construct a surgical bypass around the blocked duct. In this procedure, your surgeon will reroute the flow of bile from your common bile duct to your small intestine, constructing a detour around your pancreas.

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