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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.

Depending upon where the cancer is located in your pancreas, your doctor may:

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

You will be in the hospital for about a week 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.

Depending on the type of surgery you had, you may need to take enzyme supplements to replace the digestive enzymes made by the pancreas. In rare cases, the entire pancreas is removed, causing diabetes. If this is the case, you will need insulin to maintain blood sugar levels.

How do you prepare for surgery?

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

Preparing for surgery

  • You may be asked to follow a clear liquid diet for several days before surgery. Your doctor will tell you how to do this.
  • If you are expected to have a distal or total pancreatectomy, you may be given one or more vaccines.
  • 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.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own. 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.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options. Bring a list of questions to ask your doctors.
  • If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
  • Tell your doctor ALL the medicines and natural health products you take, including any vitamins and supplements. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.
  • 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.

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.

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.

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

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