About the pancreas

The main function of the pancreas in the digestive system is to secrete hormones and digestive enzymes and regulate the body’s glucose (sugar) balance.

The pancreas is located in the upper abdomen, surrounded by key organs, vital blood vessels, and nerves.

Pancreatic cancer

Pancreatic cancer, the fourth leading cause of cancer death in the world, is one of the most complex and problematic types of cancer to treat. This is because access to the area is limited and the pancreas is close to many vital blood vessels that could be impaired during treatment.

Adenocarcinoma, the most common type of pancreatic cancer, affects the cells that surround the pancreatic ducts.

Until recently, most pancreatic cancers were considered inoperable. Fortunately, Assuta offers surgical and non-surgical technologies and expertise to treat many more pancreatic cancers.

The Whipple procedure: pancreaticoduodenectomy

The Whipple procedure is a common surgery used to treat cancer of the pancreas, intestine, and bile duct.

During this complex operation, the surgeon removes the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder, part of the stomach, and the distal bile ducts. The remaining parts of the pancreas, bile ducts, and stomach are connected to the remaining small intestine to support the continuity and function of the digestive system. This operation is named after the surgeon who first performed it.

The Whipple procedure is considered one of the most complex surgeries, so it is important for patients to choose a surgeon with proven skill and experience in the procedure.


The procedure can have serious risks; however, it can provide a lifesaving solution.

Potential procedure complications

Whipple surgery is one of the most complex surgeries, and typically, hospitalization duration will be lengthy.

Both the Whipple procedure to remove the head of the pancreas and distal pancreatectomy to remove the tail of the pancreas can be accompanied by complications. An infection in the area of the surgical wound can occur, but in minimally invasive surgery the risk is significantly reduced. Patients can also experience bleeding from the gastrointestinal tract or damage to organs in the abdominal cavity.

About three to four percent of patients are at risk of death, in part due to internal bleeding or pancreatic fluid leakage from the sutures, a cardiac event, or a stroke, which may occur during the surgery or up to about one or two weeks afterward.

In addition, during the first year after pancreatic resection, patients have a small risk of developing diabetes because the pancreas produces the hormone insulin, which helps balance glucose levels in the blood. Patients can also develop pancreatic insufficiency, inhibiting the body’s ability to produce digestive enzymes. This should not impair quality of life because patients can take digestive enzymes.

Some patients may lose weight – about 22–33 lb. (10–15 kg) – due to changes in the structure of the digestive system and/or difficulty in eating normally. But, in most cases, patients will adapt to the new structure within about one to six months and return to normal functioning.

Distal pancreatectomy: Surgery to remove the tail of the pancreas

 During a distal pancreatectomy, the body and tail of the pancreas and the spleen are excised. Whenever possible, this surgery is performed laparoscopically (as a minimally invasive procedure).

Considerations for inoperable cancer

When the pancreatic tumor is not operable, and the tumor blocks the stomach outlet or bile ducts, the surgeon may perform a bypass. The bypass does not treat the tumor itself, but may help relieve some of the patient’s symptoms.