Dr. Bennett Roth on Digestive and Nutritional Issues Following Surgery for Pancreatic Cancer

Digestive and Nutritional Issues Following Surgery for Pancreatic Cancer

The most common surgical procedure employed in treating pancreatic cancer is the Whipple Procedure. This involves resection of the head of the pancreas along with the adjacent duodenum, gall bladder, distal bile duct and oftentimes the lower portion of the stomach. Frequently, the stomach may be spared with what is called a pylorus preserving Whipple. (Please see web site for a diagram of the surgery).

There are consequences to this surgery that can be divided into early post-operative events and nutritional and digestive issues that ensue over time.

The early issues include delayed emptying of the stomach, which can occur in 15-25% of patients and is usually transient. Rarely, medications are needed to help improve emptying. Exclusion of "leaks" at sites of anastomoses (connection sites of two organs) is mandatory if persistent delays in emptying occur.

Long-term nutritional and digestive problems include:

Weight loss
Diarrhea
"Dumping"
Inadequate pancreatic enzyme production
Diabetes
Mineral and Vitamin deficiencies