Endoscopic treatments

Surgery can be used to relieve the symptoms caused by a pancreatic tumour, such as jaundice, a bowel blockage and pain.

Stents and bypass surgery

Jaundice is a condition that happens due to a blockage in the bile duct. If this happens you may:

• feel sick (nauseous) and vomit
• feel very itchy, weak and tired
• have pain or discomfort in your abdominal area.
• get a yellow colour in your skin and the whites of your eyes. 

These symptoms can happen with localised disease, but they can also happen if your cancer is advanced and curative surgery isn’t an option. Your doctor may decide to put a small tube (stent) into the bile duct to hold the duct open and relieve the blockage. This can be done using an endoscope and is usually successful.

If you can’t have a stent, or it hasn’t been successful (which is rare), your specialist may do it radiologically (percutaneous transhepatic approach), or suggest an operation called a choledochojejunostomy or hepaticojejunostomy. This means cutting the bile duct above the blockage and then reconnecting it to the small bowel. This allows bile to bypass the blocked bile duct and drain out. Although recovering from an operation can be challenging, it is usually worth it, as it almost always relieves the jaundice and other symptoms.

Sometimes the pancreatic cancer causes a partial or complete bowel blockage (obstruction) in the small bowel (duodenum). This is a serious problem and can make you feel very sick. Anything you eat or drink can’t pass into the bowel as it normally would. It sits in the stomach and eventually you will vomit it back up again. You may also get cramping pain and swelling in the abdominal area.

To relieve this, your doctor may suggest putting a tube (stent) into the duodenum to keep it open. Or your doctor may recommend an operation to bypass the blockage. You would need to discuss the pros and cons of this operation with your doctor.

Celiac plexus block

Pancreatic cancer can cause intense abdominal pain caused by the tumour pressing on nearby organs. Your doctor may recommend a procedure called a celiac plexus block to help control your pain. This involves an injection to damage the celiac nerves, a bundle of nerves located behind the pancreas. This inhibits your nerves from sending pain messages to your brain and may provide temporary or long-term pain relief. A celiac plexus block can be done during surgery, during an endoscopic ultrasound or by inserting a needle through the skin.