As with all major operations, recovering from pancreatic surgery takes time. Full recovery requires an average of two months. Your recovery can be divided into different stages, each of which carry a different set of expectations. However, it is important to remember that every patient's recovery is different, even patients undergoing the exact same procedure.
Patients spend an average of 3-10 days in the hospital after pancreas surgery. While you are in the hospital, many members of your health care team will be checking in on you daily. Your in-house team consists of residents, medical students, nurses, and your surgeon. Your team will closely monitor your progress throughout your stay. You will be seen by residents and nurses several times each day and by your surgeon and/or one of our Pancreas Center surgeons at least once each day.
It is normal to experience pain after pancreas surgery. While in the hospital, you will be able to manage your pain with intravenous pain medication. Once you are at home, you will manage your pain with oral medications prescribed by your health care team.
After your operation, you will have staples and special dressings where incisions were made during your procedure. You may also have some surgical drainage tubes left in your abdomen. Your team will check your dressings regularly to ensure they are healing well and monitor any tubes to ensure proper drainage. It is normal to be discharged home with the surgical drainage tubes still in place, so do not be worried about your recovery if this happens to you. You will be given specific instructions on how to care for both the drainage tubes and your surgical dressing before you are discharged from the hospital; both will be removed during one of your postoperative visits to the Pancreas Center.
Due to a condition known as "gastric ileus," or temporary paralysis of the stomach, you will not be able to eat for many days after your surgery. While you are in the hospital, your health care team will ensure you receive proper hydration intravenously. There is no way to predict how quickly your stomach will regain its full function after an operation, and patients must undergo a trial-and-error process as they attempt to resume normal eating. While this process can be frustrating, it is also perfectly normal. You will not be discharged from the hospital until you can tolerate food and liquid, however it still may take several weeks before your digestive system returns to "normal."
Many people are eager to be discharged from the hospital after surgery, and your health care team will do everything they can to return you to your home life. Before we can discharge you, though, there are certain requirements you must meet. You should:
- Have no unresolved medical or surgical issues
- Have a stable temperature and not show signs of fever
- Be able to walk unassisted
- Be able to tolerate food and liquid
- Be able to perform basic activities of daily living like brushing your teeth and washing your hair
Once you meet these requirements, you will be eligible for discharge. In some instances, especially in cases of elderly patients, we may recommend a stay in a skilled nursing or rehabilitation facility before going home. Recovering from a major operation like pancreas surgery can be difficult and it helps to have trained professionals to assist in your recovery. This option may be addressed during your preoperative evaluation, but is often better defined directly after surgery.
While you will be able to leave the hospital after a few days or weeks, remember that a full recovery from pancreas surgery can take two months or longer. During the first two months, we will ask you to come into the Pancreas Center clinical office every two weeks for postoperative evaluations. At your first postoperative visit, you will meet with your surgeon and/or a nurse practitioner who will review your pathology and surgical reports. Your incisions will be examined and staples and tubes will be removed. At this, and at subsequent postoperative evaluations, your team will also talk to you about your diet, bowel functions, and pain control to ensure you are recovering well. It may help to keep a journal of what you are eating and drinking, how much of it you are consuming, and at what times you are able to eat. This will not only help your conversation with your health care team during your postoperative visits, but will help you understand what kinds of foods you are tolerating. If you are having issues with your diet, your doctor/nurse may refer you to our clinical nutritionist to help you with your individual needs.
After the first two months of very regular postoperative evaluations with the Pancreas Center surgery team, frequency of your follow up evaluations will be reduced to every 3-6 months. Depending on the type of resection and the resulting pathology, we may also ask you to undergo regular imaging studies such as MRI or CT to check for recurrence of cancer. We will also perform regular blood tests to ensure important indicators like tumor markers and liver function tests remain within normal ranges.
Most patients who undergo surgery for pancreatic cancer will also require a course of chemotherapy after their operation, known as adjuvant chemotherapy. Your surgeon will refer you to a Pancreas Center oncologist or coordinate with a specialist closer to home. Since chemotherapy requires regular treatment over a period of time, it is important that you receive your therapy at a location convenient for you. Adjuvant treatment does not normally start until six to eight weeks after surgery.
Post-Operative Dietary Guidelines
After pancreatic surgery, it is normal to have difficulty eating or to experience nausea, vomiting or heartburn. These symptoms are caused by a condition known as "gastric ileus," or temporary paralysis of the stomach. It may take your digestive system anywhere from a few weeks to a few months to return to normal. There is no way to predict how quickly your stomach will regain full function, and patients must undergo a trial-and-error process as they attempt to resume normal eating. In some cases, patients find they must make permanent changes to their diet in order to alleviate diarrhea, gas, and stomach pain. In situations where gastric ileus persists, a supplemental feeding tube and/or a special IV called a PICC line can help to ensure the patient receives proper nutrients.
In general, when recovering from a pancreatic operation, the goal should be to eat small, frequent meals/snacks every three hours. Eat a protein containing food first each meal to minimize the amount of muscle mass you may lose. It is important to remember to drink fluids between meals to stay hydrated. Our clinical nutritionist has created a handout to help you anticipate what to expect after your surgery including food recommendations and some helpful tips for minimizing gastrointestinal upset.