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Surgery for pancreatic cancer - discharge

Pancreaticoduodenectomy; Whipple procedure; Open distal pancreatectomy and splenectomy; Laparoscopic distal pancreatectomy

You had surgery to treat pancreatic cancer.

Now that you're going home, follow instructions on self-care.

I Would Like to Learn About:

When You're in the Hospital

All or part of your pancreas was removed after you were given general anesthesia so you were asleep and pain-free.

Your surgeon made an incision (cut) in the middle of your belly. It may have been horizontal (sideways) or vertical (up and down). Your gallbladder, bile duct, spleen, parts of your stomach and small intestine, and lymph nodes may also have been taken out.

What to Expect at Home

Your surgeon will give you a prescription for pain medicines. Get it filled when you go home so you have it when you need it. Take your pain medicine when you start having pain. Waiting too long to take it will allow your pain to get worse than it should.

You may have staples in the wound, or dissolving stitches under the skin with a liquid adhesive on the skin. Mild redness and swelling for the first couple of weeks are normal. Pain around the wound site will last 1 or 2 weeks. It should get better each day.

You will have bruising or skin redness around your wound. This will go away on its own.

You may have drains at the site of your surgery when you leave the hospital. The nurse will tell you how to care for the drains.

Do not take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn), unless directed by your surgeon, as these medicines may increase bleeding.

Activity

You should be able to do most of your regular activities in 6 to 8 weeks. Before that:

• Do not lift anything heavier than 10 to 15 pounds (4.5 to 7 kilograms) until you see your surgeon.
• Avoid all strenuous activity. This includes heavy exercising, weightlifting, and other activities that make you breathe hard or strain.
• Taking short walks and using stairs are OK.
• Light housework is OK.
• Do not push yourself too hard. Gradually increase how much you exercise.
• Learn what you can do to keep yourself safe in the bathroom and prevent falls at home.

Wound Care

Your surgeon or nurse will explain how to care for your surgical wound. You may remove the wound dressings (bandages) and take showers if sutures (stitches), staples, or glue were used to close your skin.

If staples were used to close your incision, your surgeon will remove them about a week or so after surgery.

If tape strips were used to close your incision:

• Cover your incision with plastic wrap before showering for the first couple of days after surgery.
• Do not try to wash off the tape strips. They will fall off on their own in about a week.
• Do not soak in a bathtub or hot tub or go swimming until your surgeon tells you it is OK.

Diet and Nutrition

Before you leave the hospital, check with the dietitian about what foods you should eat at home.

• You may need to take pancreatic enzymes and insulin after your surgery. Your surgeon will prescribe these if needed. It may take time to get to the right dosages of these medicines. Your surgeon or health care provider will help you adjust the dosages.
• Be aware that you may have trouble digesting fat after your surgery.
• Try to eat foods that are high in protein and carbohydrates and low in fat. It may be easier to eat several small meals instead of large ones.
• Tell your surgeon or provider if you are having a problem with loose stools (diarrhea).

Follow-up

You'll be scheduled for a follow-up visit with your surgeon 1 to 2 weeks after you leave the hospital. Be sure to keep the appointment.

You may need other cancer treatments such as chemotherapy or radiation. Discuss these with your provider.

When to Call the Doctor

Contact your surgeon if:

• You have a fever of 101°F (38.3°C) or higher.
• Your surgical wound is bleeding, or is red or warm to the touch.
• You have problems with the drain.
• Your surgical wound has thick, red, brown, yellow or green, or milky drainage.
• You have pain that is not helped with your pain medicines.
• It is hard to breathe.
• You have a cough that does not go away.
• You cannot drink or eat.
• You have nausea, diarrhea or constipation that is not controlled.
• Your skin or the white part of your eyes turns yellow.
• Your stools are a gray color.

References

Debrin JA. Pancreatic cancer: clinical aspects, assessment, and management. In: Jarnagin WR, Allen PJ, Chapman WC, et al, eds. Blumgart's Surgery of the Liver, Biliary Tract and Pancreas. 7th ed. Philadelphia, PA: Elsevier; 2023:chap 62.

Modi B, Shires T. Pancreatic cancer, cystic pancreatic neoplasms, and other nonendocrine pancreatic tumors. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 60.

Review Date: 9/9/2023  

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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