Pancreatectomy (pancreas surgery)

A pancreatectomy is an operation to remove part or all of the pancreas. It can be recommended to treat pancreatic cancer, some pancreatic tumors, or certain precancerous cysts. In many cases, surgeons can use smaller incisions (minimally invasive or robotic techniques) depending on your anatomy and the specifics of your condition.

This page explains when surgery is considered, the main types of pancreatectomy, what to expect before and after the operation, risks to be aware of, and how UC Health supports you throughout care.

Surgery is tailored to the location of the problem within the pancreas and your overall health. Your surgeon will review the safest option for you and whether a minimally invasive approach is appropriate.

• Whipple procedure (pancreaticoduodenectomy): Removes the head of the pancreas along with nearby structures (first part of the small intestine, gallbladder, part of the bile duct, and sometimes part of the stomach). The digestive tract is then reconnected so food and digestive juices can flow normally. A common variant keeps the stomach’s pylorus (pylorus-preserving Whipple).
• Distal pancreatectomy: Removes the body and tail of the pancreas. Depending on the tumor’s location, your surgeon may remove a larger portion—sometimes called a subtotal distal pancreatectomy. The spleen may be removed at the same time when medically necessary.
• Total pancreatectomy: Removes the entire pancreas (and often the spleen). After this operation, you will need insulin for diabetes and pancreatic enzyme capsules to help with digestion. For select patients with severe chronic pancreatitis, your team may offer total pancreatectomy with islet autotransplantation (TPIAT), which moves your own islet cells to the liver to help make insulin; TPIAT is not used to treat pancreatic cancer.

When appropriate for select benign or low-grade tumors, your surgeon may discuss specialized options such as central pancreatectomy (removing only the middle portion) or enucleation (removing just the small lesion). Rarely, advanced operations like DP-CAR are considered for specific, locally advanced cancers.

When Surgery is Recommended

Surgery may be considered for:

• Pancreatic ductal adenocarcinoma (pancreatic cancer)
• Precancerous cysts, such as intraductal papillary mucinous neoplasm (IPMN)
• Pancreatic neuroendocrine tumors
• Select cases of severe chronic pancreatitis when other treatments haven’t helped

Choosing surgery starts with a careful evaluation. Most patients have a medical history and exam, blood work, and a high‑quality pancreas‑protocol CT or MRI to show the pancreas and nearby blood vessels clearly. Some people also need endoscopic tests: EUS (endoscopic ultrasound) or ERCP, to gather more information or relieve jaundice. Your case is then discussed at our multidisciplinary tumor board.

You may hear your team describe what imaging shows about the tumor and nearby blood vessels:

• Resectable: The tumor can be removed safely; surgery is usually recommended.
• Borderline resectable: The tumor touches nearby blood vessels in a limited way; chemotherapy (and sometimes radiation) is often used first, then surgery if appropriate.
• Locally advanced/unresectable: The tumor involves major arteries or veins in a way that prevents safe reconstruction; treatment focuses on chemotherapy and/or radiation.

Before Surgery and How to Prepare for a Pancrectomy

In the weeks before surgery, you’ll meet with anesthesia and your surgical team to review tests, plan pain control, and go over your medications. We’ll help you get ready at home and answer questions so the day of surgery goes smoothly.

• Pre‑op visit and tests: Most people have a pre‑anesthesia assessment, blood work, an ECG, and any imaging or endoscopic tests your team needs. We’ll confirm allergies, review your medicines and supplements, and ask you to sign consent forms after we answer your questions.
• Optimize your health: Quitting smoking or vaping, limiting alcohol, daily walking, and simple breathing exercises lower the chance of complications. Eating enough protein (and meeting with a dietitian if needed) supports healing.
• Medicine plan: We’ll tell you which medicines to take or pause before surgery. This may include blood thinners, some diabetes medicines (including certain injections), and herbal supplements. If you use insulin, an insulin pump, or a CPAP device for sleep apnea, we’ll give you specific instructions.
• If the spleen may be removed: Some distal or total pancreatectomies include spleen removal. Your team will discuss vaccines to protect against infections and the best timing for them.
• Eating and drinking: We’ll give you exact instructions about when to stop solid food and when you can have clear liquids. Some patients receive a carbohydrate drink as part of our Enhanced Recovery After Surgery (ERAS) pathway.
• Preventing infection: You may be asked to shower with a special antiseptic soap the night before and the morning of surgery. Please don’t shave near the surgical area.
• Plan for home and support: Arrange a ride home and a support person for the first week. Set up a comfortable place to rest, gather easy‑to‑digest foods, and pick up any prescriptions. Talk with your employer about time off if needed.
• What to bring. Photo ID and insurance card, a list of your medicines, your CPAP (if you use one), and comfortable shoes. Leave jewelry and valuables at home.

The Day of Surgery

You’ll meet the anesthesia and surgical teams and review your plan for pain control. Surgery often takes several hours. During the operation, we will keep your family or support person updated. After surgery, you’ll recover in a monitored unit (ICU or recovery area) so we can watch you closely.

In the Hospital

Most patients start with liquids and advance diet as they are ready. A temporary drain may be placed near the pancreas. Walking, breathing exercises, and good pain control help prevent complications and speed recovery. Before you go home, we’ll review incision care, activity, diet, and medications.

All major surgeries have risks such as bleeding, infection, blood clots, pneumonia, heart or lung problems, and reactions to anesthesia. Risks more specific to pancreatectomy include pancreatic leak (fistula), delayed stomach emptying, bile leak, bowel blockage (ileus), bleeding from nearby blood vessels, new or worsening diabetes, and digestive changes from fewer pancreatic enzymes (gas, bloating, weight loss, greasy stools). Your surgeon will discuss your personal risk and how we prevent and manage problems.

Recovery looks different for everyone, but most people can return to regular activities over time.

• Eating and digestion: Small, frequent meals are often easier at first. Many people need pancreatic enzyme capsules with meals and snacks to help digestion. A dietitian can help tailor your plan.
• Blood sugar: You may need to monitor your blood sugar after surgery. After a total pancreatectomy, insulin is required.
• Activity: Gentle walking starts right away. Avoid heavy lifting until your team says it’s OK.
• Follow‑up: You’ll have clinic visits and, if you were treated for cancer, follow‑up with oncology. Some people need additional therapy.

When to Call Your Care Provider

Call your care team if you have:

• Fever over 101°F (38.3°C)
• Worsening belly pain, vomiting, or inability to keep liquids down
• Redness, drainage, or opening at the incision
• Yellowing of the skin or eyes (jaundice)
• Signs of dehydration: dizziness, very dark urine, dry mouth

At the UC Health Pancreatic Disease Center, you’re cared for by a team that focuses on pancreatic conditions. Our specialists in gastroenterology, surgical oncology, medical oncology, radiology and radiation oncology work side by side to plan your care. As a National Pancreas Foundation–designated Center of Excellence and the region’s adult academic medical center, we combine advanced imaging and endoscopy, high volume surgery (including minimally invasive options), and access to clinical trials—all in one coordinated program.

From your first visit through recovery, we make each step clear. We help you prepare for appointments, arrange the right scans and endoscopic tests, and connect you with support. If surgery is part of your plan, our surgeons perform Whipple, distal and total pancreatectomy, and—for select cases of severe chronic pancreatitis—total pancreatectomy with islet autotransplantation (TPIAT). Your team will explain which option fits your diagnosis and goals.

To schedule an appointment with our care team, please call 513-585-8222.