The pancreas is an organ located at the upper abdomen, and it lies behind the stomach. Within the pancreas is a system of small tubes, also known as pancreatic ducts, which transports enzymes produced by the pancreas into the small intestine to help digestion. The pancreas also produces a number of hormones to regulate body functions. One of these hormones is insulin, which regulates our blood sugar level.
Although there are a few types of tumours that can grow in the pancreas, when doctors talk about pancreas cancer, we usually refer to a cancer of the cells lining the ducts within the pancreas. Therefore, the scientific medical term for this type of cancer is known as pancreatic ductal adenocarcinoma. This is a very aggressive cancer. Only 1 out of 10 patients who have this disease can be treated by surgery. This is because most patients, upon diagnosis, are already at an advanced stage.
Generally there are 2 groups of people whom we see for pancreas cancer.
The first group are those who complained of one or more of the symptoms listed above.
The second group are those who have gone for some form of medical check-up and were found by chance to have some abnormalities.
This may include elevation of cancer markers, in particular CA 19-9.
Or they may have gone for some scans, like an ultrasound scan or CT scan, and may have been discovered to have a growth in the pancreas.
Depending on what the stage of the cancer is, the doctor will then decide on the appropriate treatment. If the cancer is advanced and has spread beyond the pancreas, the doctor will recommend chemotherapy or radiotherapy or both.
If the cancer is still confined to the pancreas, surgery is possible. Surgery offers the best hope. The type of surgery depends on the location of the cancer in the pancreas.
If the cancer or tumour is located in the head of the pancreas or the uncinate process of the pancreas, the name of the operation is called Whipple operation or Pancreaticoduodenectomy:
The Whipple operation is an operation to remove the head of the pancreas, along with the duodenum, a portion of the bile duct, the gallbladder, and a portion of the stomach.
After removal of these structures the remaining pancreas, bile duct and the stomach are then stitched back to the intestine to reconstitute the continuity of the digestive tract.
Pylorus-preserving pancreatico-duodenectomy surgery is similar to Whipple Operation and the difference is the entire stomach is preserved and not removed. PPPD is said to allow better long-term digestive function and better quality of life.
Whipple operation is a major operation that requires around 6-8 hours to complete. Because this is a major operation, there is usually a need to monitor the patient in the High Dependency Unit or Intensive Care Unit immediately after the operation, usually for 1 to 3 days.
The patient will have a nasogastric tube and a urine catheter. In addition, there will be one to two surgical tubes placed into the abdomen to remove any residual fluid or blood. The patient would not be allowed to eat for a couple of days. Intravenous fluid will be given for hydration as well as nutrition.
The average length of stay is 10-14 days. If there are any complications, the length of stay will be prolonged.
If the cancer or the tumour is located in the body and/or tail of the pancreas, the surgeon can either perform a subtotal pancreatectomy or distal pancreatectomy.
Distal Pancreatectomy is an operation to remove the tail of the pancreas along with part of or the entire body of the pancreas. Unlike the Whipple operation, the head of the pancreas, the duodenum, the bile duct and the stomach do not need to be removed. Hence it is an easier operation compared to the Whipple operation.
Depending on the nature of the disease, this operation can be combined with the removal of the spleen. In selected cases, the spleen can be preserved. This technique is called the spleen-preserving distal pancreatectomy.
Advantages of preserving the spleen are:
Options for such operations are as follows:
If a person is told that there is a “tumour” in the pancreas and would like to know if an operation is needed, and what type of technique is suitable for the condition, please do not hesitate to contact us.
Due to the complexity of the operation, do consider seeking advice from a Hepatobiliary and Pancreatic surgeon.
Our surgeons will have to review your situation and come out with a customised solution that best address your clinical problem.
Cancers, including cancer of the pancreas, are due to genetic mutations of the cells.
As a result of these gene mutations, the pancreas cells start to multiply uncontrollably. These cells also have the ability to detach from the pancreas and invade into the bloodstream and spread to other parts of the body, or invade into the adjacent organs around the pancreas.
What are the risk factors of developing pancreas cancer?
The surgical operations to treat a pancreatic cancer are all complex procedures. Ideally they should be done by a hepatobiliary surgeon. This is a specialist who has received special training in such complex procedures.
Depending on the location of the cancer within the pancreas, the operation to be performed may be either to:
Based on the Ministry of Health (Singapore) historical transacted billsizes and fee benchmark, for this operation:
However, other factors that can affect the final bill includes your insurance plan and coverage for Co-payments and Deductibles as well as Medisave withdrawals.
This procedure is a Medisave claimable procedure. The Medisave withdrawal limit for this procedure is S$5290.
Based on the Ministry of Health (Singapore) historical transacted billsizes and fee benchmark, for this operation:
However, other factors that can affect the final bill includes your insurance plan and coverage for Co-payments and Deductibles as well as Medisave withdrawals.
This procedure is a Medisave claimable procedure. The Medisave withdrawal limit for this procedure is S$2770.
The answer is yes. These may be less aggressive, and therefore cure is quite possible. Examples are:
These are some alternative surgical techniques to remove such tumours, and it include laparoscopic or keyhole operations. Other options include:
Colorectal & General Surgeon
Upper Gastrointestinal, Bariatric & General Surgeon
Nexus Surgical provides comprehensive financial services to ensure a seamless and pleasant experience.
Our clinics will be closed from 16 – 18 Feb for CNY
Our clinic at Mt Alvernia Medical Centre A will be relocating from #06-05 to #03-03 (within the same building) on Friday, 26 Sep afternoon.
Our telephone line 6353 4855 will be temporarily unavailable from 12:00pm – 6:00pm on 26 September. During this period, you may reach out to our other clinics for assistance:
We will begin operations at our new premises (#03-03) from Tuesday, 30 Sep onwards.
We look forward to serving you at our new clinic!
Nexus Surgical clinics at Mt Elizabeth Novena Specialist Centre, Gleneagles Medical Centre, Parkway East Medical Centre and Mt Alvernia Medical Centre will be closed on 28 January 2025 for Lunar New Year celebrations, while our clinic at Mt Elizabeth Orchard Medical Centre remains open from 0900-1300 hours on 28 January 2025.
Please leave a message in our voice mails and we will respond to you as soon as we can when we resume our clinics on 31 January 2025. If you require any urgent assistance, kindly go to the Urgent Care Centre of any hospitals or contact your doctor through the Emergency Answering Service. Our team at Nexus Surgical would like to take this opportunity to wish you and your loved ones a Happy & Prosperous Lunar New Year with good health in the Year of the Snake!
Nexus Surgical will be away from 17 to 20 October 2024 for our Annual Company Retreat. The aim of our retreat is to review and to recharge, so that we may serve you better.
Our clinics at Mount Elizabeth Orchard, Mount Elizabeth Novena, Mount Alvernia and Parkway East hospitals will therefore be closed during this period. In the meantime, if you require any urgent assistance, kindly contact us through our Answering Service at +65 6333 5550.
We thank you for your understanding and patience for any inconvenience.
