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Surgery for pancreatic cancer - discharge

Definition

Pancreatic surgery is done to treat cancer of the pancreas gland.

Alternative Names

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

When You Are 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, and parts of your stomach, small intestine, and lymph node may also have been taken out.

You will be in the recovery room when you wake up after surgery. You will be moved to a regular hospital room after a few hours if you are stable.

You will have an intravenous (IV) catheter in your arm to get fluids and medicines. You will also get pain medicine through the IV.

You will have a tube in your nose for about 2 days.

You may have drains in your abdomen to prevent blood and other fluid from building up. 

You will have special stockings on your legs to prevent blood clots.

You may need to get insulin shots

You will be given clear fluids at first. You can start eating regular foods when your intestines and pancreas are healed.

The nurse will help you move to a chair and start taking a few steps within 24 to 48 hours after your surgery.

Most people stay in the hospital 1 to 2 weeks after surgery.

What To Expect at Home

Your doctor 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 will have staples in the wound. 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 also have a small amount of watery or dark bloody fluid from the wound for several days.

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

DO NOT take aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn), as these medicines may increase bleeding.

Activity

Plan to have someone drive you home from the hospital. DO NOT drive yourself home.

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 doctor.
  • 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. Increase how much you exercise slowly.
  • Learn what you can do to keep yourself safe in the bathroom and prevent falls at home.

Wound care

Your health care provider 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 stitches or staples were used to close your incision, your doctor will remove them at your first follow up visit.

If tape strips (Steri-Strips) were used to close your incision:

  • Cover your incision with plastic wrap before showering for the first week.
  • DO NOT try to wash off the Steri-Strips or glue. 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 doctor tells you it is ok.

Diet and Nutrition

You should:

  • Ask the nutritionist dietitian before you leave the hospital what foods you can eat at home.
  • Know you may need to take pancreatic enzymes and insulin after your surgery. Your doctor will prescribe these if necessary. It may take time to get the right doses of these medicines.
  • Know you may have trouble digesting fat after your surgery.
  • Try to eat foods that are high in protein and carbohydrates and low in fat, may be easier to eat several small meals instead of large ones.
  • Tell your provider if you are have a problem with loose stools (diarrhea).

Follow-up

You:

  • Will need to see your doctor for a follow up visit 1 to 2 weeks after you leave the hospital days.
  • May need other cancer treatments such as chemotherapy or radiation.

When To Call the Doctor

Call your doctor if:

  • You have a fever over 101°F (38.3°C).
  • Your surgical wound is bleeding, are 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

Claudius C, Lillemoe KD. Palliative Therapy for Pancreatic Cancer. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 11th ed. Philadelphia, PA: Saunders Elsevier; 2014:481-487.

Jensen EH, Borja-Cacho D, Al-Refaie WB, Vickers SM. Exocrine Pancreas. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 56.

Mauro LA, HermanJM, Jaffee EM, Laheru DA. Carcinoma of the Pancreas. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 81.

Review Date:5/20/2015
Reviewed By:John A. Daller, MD, PhD., Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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