Why is this procedure done?
Surgery to remove all or part of your pancreas is a pancreatectomy. The pancreas is an organ in your belly. It makes and releases juices to help break down food. It makes a hormone called insulin to control the sugar levels in your blood. ‚
A Whipple procedure is a kind of pancreatectomy. The doctor removes the gallbladder, part of the stomach, parts of the pancreas, the small intestine, and the bile duct during the surgery. Your doctor will leave enough of the pancreas to make juices for digestion and insulin. ‚
This surgery may be used when there is a tumor in the pancreas and other organs in the belly. The tumor may or may not be cancer. This surgery may be done to remove cysts or tumors in the bile duct or part of the stomach. Radiation or chemo may be used before surgery to try to shrink the tumor. ‚
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What will the results be?
The surgery will remove the diseased part or the pancreas. It will prevent the spread of cancer cells to other parts of the body or remove those cells that have already spread. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- X-rays
- Angiography
- Ultrasound
- CT or MRI scan
- Endoscopic retrograde cholangiopancreatography
What happens during the procedure?
- Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- When you are asleep, the doctors put a tube in your mouth to help you breathe. They may also put another small tube in your nose. This one goes down to your stomach to drain out any food or fluid that might come out during surgery. You may have a tube in your bladder to drain urine.
- The surgery is done as an open procedure, with a larger cut, or laparoscopically with a few small cuts. The doctor will talk to you about the best way to do your surgery.
- Open Procedure:
- Your doctor will make a large cut in your upper belly to see the pancreas and other parts.
- The pancreas and other organs are taken out.
- Your doctor will sew your stomach and bowels back together after taking out the bad part of the pancreas.
- Your doctor will close your cut with stitches or staples and cover it with clean bandages.
- Laparoscopic Procedure:
- Your doctor will make few small cuts in your belly. A scope with a tiny camera is put through one of the small cuts. Your doctor will put small surgical tools into the holes to do the procedure. To be able to view the site, gas will be put into the abdomen. Then, the pancreas or other organs will be taken out. Your stomach and bowels are sewn back together. Your doctor will close your cut with stitches or staples and cover them with clean bandages.
- Your doctor may put a tube into your stomach or intestines to help prevent upset stomach and throwing up. Then it will be used as a feeding tube while you are healing.
- The procedure takes 5 to 8 hours.
What happens after the procedure?
- You will go to the Recovery Room or Intensive Care Unit after the surgery and the staff will watch you closely. The staff will monitor your heartbeat, blood pressure, and breathing and give you drugs for pain.
- You may have discomfort and numbness after the procedure. This may become more painful when the anesthesia wears off. Your doctor will give you drugs for this.
- There will be tubes in your arms, nose, and in your wound. Keep these in place. Your doctor may remove the tubes after 3 to 5 days.
- You will not be able to eat for a few days to let your stomach heal.
- Later that day or the next, you will get out of bed. The staff will help you begin to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear. Use a pillow against your belly to support your wound when coughing.
- You will stay in the hospital for 5 to 7 days.
- Brush your teeth and rinse your mouth often. This will help to keep your mouth clean and moist. Use petroleum jelly on your lips to help with lip dryness.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Get lots of rest. Rest when you are feeling tired.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, or sex
- Be sure to wash your hands before touching your wound or dressing.
- Your doctor may ask you to keep a record of your blood sugar readings. Your doctor may have you meet with the diabetes educator while you are in the hospital. The educator will talk with you about using a blood sugar meter. This is a glucometer. This person will tell you what to do if your blood sugar is too high or too low. The diabetes educator will also teach you how to take your drugs for blood sugar or your insulin shots.
- If your doctor put in a tube for feeding, you will learn how to use it. Follow your doctors instructions.
What follow-up care is needed?
- Your condition needs close monitoring. Your doctor will ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- Your doctor will tell you if you need other tests.
- You may be asked to see a dietitian to plan for the right diet for you.
What lifestyle changes are needed?
- Avoid getting into sports that involve rough contact to your belly.
- Avoid smoking and drinking beer, wine, and mixed drinks (alcohol).
- Eat small meals more often to keep your blood sugar at a steady level.
What problems could happen?
- Bleeding
- Infection
- Loose stools
- Diabetes
- Delayed emptying of your bowels
- Leaks from the reconnection of your bowels
- Blood clots in the legs or lungs
- Heart, lung, or kidney problems
Where can I learn more?
American Cancer Society ‚
http://www.cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-treating-surgery ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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