Pancreatic cancer is often already in an advanced stage when it is discovered. Unfortunately, sometimes, it turns out during surgery that it is not possible to remove the tumor because it has already spread or grown into the surrounding tissue. In that case, there is little point in removing the pancreas. The doctor can continue the surgery as palliative treatment, to relieve or prevent symptoms. The most common treatments are:
- against fluid retention (water belly / ascites, text in Dutch only).
- pain relief (text in Dutch only).
- stent against jaundice (text in Dutch only).
Palliative surgery
Cancers that grow in the head of the pancreas can block the common bile duct. This can lead to pain and digestive problems because bile can’t flow to the intestine.
There are two options for relieving bile duct blockage.
Surgery may be done to redirect the flow of bile from the common bile duct directly into the small intestine, bypassing the pancreas.
A second approach to relieving a blocked bile duct does not involve surgery. Instead, a stent (text in Dutch only) is placed to keep the bile duct open. This is usually done through an endoscope (a long, flexible tube).
The tumor can also obstruct the passage of food from the stomach to the duodenum. For this, the surgeon can create a bypass by connecting the stomach directly to the small intestine, thereby bypassing the duodenum. There are also developments to place a stent or make a connection between the stomach and intestine using an endoscope.
If during surgery it appears that the tumor cannot be removed (irresectable), the surgeon will connect both the bile duct to the intestine and the stomach to the intestine to prevent future flow obstruction.