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Pancreatic Cancer Surgery: Before Your Surgery

What is surgery for pancreatic cancer?

Surgery for pancreatic cancer removes part or all of the pancreas. Other organs might also be removed. You and your doctor will plan your surgery based on your wishes and the stage of the cancer. Every person's treatment plan and surgery are different. Your doctor will tell you what will be removed.

Your doctor may:

  • Take out the narrow end (tail) of the pancreas and the spleen. This is called a distal pancreatectomy.
  • Take out the whole pancreas, part of the stomach, part of the small intestine, and the bile duct, gallbladder, spleen, and nearby lymph nodes. This is called a total pancreatectomy.
  • Take out the thick end (head) of the pancreas. Your doctor may also remove the body of the pancreas, part of the stomach, part of the small intestine, nearby lymph nodes, and the gallbladder and common bile duct. This is called a Whipple procedure.

You will be in the hospital for 1 to 2 weeks after the surgery. You will probably be able to go back to work or your normal routine in about 1 month. It will probably take about 3 months until your strength is back to normal. You may need more treatment for the cancer. This may include chemotherapy or radiation.

You may need to take enzyme supplements. These replace the enzymes the pancreas makes. You may also need to take anti-ulcer pills.

The pancreas makes insulin. So you may develop diabetes after surgery. If this is the case, you may have to check your blood sugar levels and take insulin.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to help you feel better while you go through treatment. Your doctor can guide you to many local resources for support and more information. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Preparing for surgery

  • Bring a list of questions to ask your doctors. It is important that you understand exactly what surgery is planned, the risks, benefits, and other options before your surgery.
  • Tell your doctors ALL the medicines and natural health products you take, including any vitamins and supplements. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • Before your surgery, you will speak with an anesthesia provider to discuss your anesthetic options, including the risks, benefits, and alternatives to each. This may be on the phone or in person.
  • You may be asked to follow a clear liquid diet for several days before surgery. Your doctor will tell you how to do this.
  • You may be given antibiotic pills to take.
  • You may need to empty your colon with an enema or laxative. Your doctor will tell you how to do this.

Taking care of yourself before surgery

  • Build healthy habits into your life. Changes are best made several weeks before surgery, since your body may react to sudden changes in your habits. Talk to your doctor about any changes you need to make.
    • Stay as active as you can.
    • Eat a healthy diet.
    • Cut back or quit alcohol and tobacco. If you drink a lot of alcohol, talk to your healthcare provider about helping you cut down the amount you drink.
  • If you have an advance care plan, let your doctor know. If you do not have one, you may want to prepare one so your doctor and loved ones know your health care wishes. Doctors recommend that everyone prepare these papers before surgery, regardless of the type of surgery or condition.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.
  • Leave your valuables at home.

At the hospital or surgery centre

  • Bring a picture ID.
  • Before surgery you will be asked to repeat your full name, what surgery you are having, and what part of your body is being operated on. The area for surgery is often marked to make sure there are no errors.
  • A small tube (IV) will be placed in a vein, to give you fluids and medicine to help you relax. Because of the combination of medicines given to keep you comfortable, you may not remember much about the operating room.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery usually takes 4 to 8 hours, depending on the type.
  • As you wake up in the recovery room, the nurse will check to be sure you are stable and comfortable. It is important for you to tell your doctor and nurse how you feel and ask questions about any concerns you may have.

Going home

  • Be sure you have someone to drive you home.
  • For your safety, you should not drive until you are no longer taking pain medicines and you can move and react easily.
  • Arrange for extra help at home after surgery, especially if you live alone or provide care for another person.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter L908 in the search box to learn more about "Pancreatic Cancer Surgery: Before Your Surgery".

Adapted with permission from copyrighted materials from Healthwise, Incorporated (Healthwise). This information does not replace the advice of a doctor. Healthwise disclaims any warranty and is not responsible or liable for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.