Considerations after your surgery
An operation to remove a pancreatic tumour can take between 4 and 8 hours.
After your operation you will usually wake up in the recovery room near to the operating theatre, where a nurse will care for you. You will then be taken to the High Dependency Unit (HDU) or occasionally the Intensive Care Unit (ITU) for 2 to 3 days so you can be monitored closely.
From there you will be taken to the specialist surgical ward. Patients usually stay in hospital for between 10 to 14 days.
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Tubes and drains
When you wake up from your operation you will have some tubes and drains attached to you. These will have been placed while you were asleep under anaesthetic. The type and number you will have depends on what type of operation you had but will often include:
- Tubes inserted into a vein in your arm and neck to provide you with fluids or medicines
- A drain is usually placed under the skin near the wound site to drain off fluid
- A catheter (a fine tube) will be placed into your bladder to collect your urine into a bag. This means you don’t have to worry about getting out of bed to go to the toilet and the nurses can monitor how much urine you are producing
- An epidural catheter system (an injection into the back) will often be used to deliver pain relief immediately following the operation
- A feeding tube either going through your nose or directly into your tummy.
Your tubes and drains will be removed as soon as your medical team feels they are no longer needed.
The amount of pain experienced differs between individuals. Your medical team will work with you to ensure pain is kept to a minimum and it is essential you tell the nurses if you are feeling pain or if that pain gets worse.
Some of the ways pain can be managed in hospital are:
- Epidural Catheter system (injection into the back usually immediately following surgery
- Painkilling injections (every 3 to 4 hours)
- Painkiller suppositories – inserted into the rectum (back passage)
- Patient-controlled analgesia (PCA) consists of a machine containing pain killer connected to a drip. You can receive a dose of pain killer by pressing a button when needed. The machine prevents too many doses being given
- Painkiller tablets
Your doctors will explain which type of pain killer they will be giving you and how often you will receive it.
For the first day or so, you will need help with washing from the nursing staff. Once all the drains have been removed the nurses will help you to have a bath or shower.
It is important to start moving around as soon as possible and you will be encouraged to get out of bed, sit in the chair, march on the spot and take short walks regularly. Some patients will be encouraged to sit upright on the evening of their operation and be out of bed the morning afterwards. This prevents stiffness, bed sores and constipation and helps keep your chest clear. You will be given a pair of surgical stockings to wear which help the blood flow in your legs and prevent clots forming.
Your wounds will be ‘stitched’ up using staples known as clips. They are usually removed about 10 days after surgery and this can be done by your GP if you have already been discharged. The dressings around your drains need to changed regularly. If you notice any leaks or discharge from around the wound, do let one of your medical team know.
Eating and drinking immediately after surgery
You will not be allowed to eat or drink immediately following surgery to allow for the intestine and pancreas to heal. This may be for a few days.
Some (but not all) patients will be fitted with a feeding tube during their operation. This tube (known as a nasojejunal tube) will go through your nose and past the site of the operation. Sometimes it can take a while for the stomach to begin emptying normally after pancreatic surgery and this tube allows you to be kept well fed with special liquid food during this time.
Your feeding tube will be removed once you are able to eat proper meals.
When your doctors are happy, you will begin with sips of water before reintroducing a light diet, soft diet and building up to eating and drinking normally again. If you weren’t taking them before, you may need pancreatic enzyme replacement therapy to ensure you are able to absorb the nutrients from your food now a portion of your pancreas is missing.
What is a light diet?
During the first days or week after surgery, your medical team and dietitian will help you to start eating a light diet. Nurses will be able to provide useful information about what foods to try. Generally, this is soft, moist and easily digested food.
When recovering from surgery and eating a light diet there are some foods and food groups to avoid;
- Spicy foods
- High fat foods
- Foods that contain lots of cheese (eg pizza, lasagne)
- High fibre foods
- Good with bits and pips in
- Fizzy drinks and alcohol
Some suggested foods for a light diet include:
|Breakfast||Porridge, cornflakes or puffed rice cereal, white bread and butter or spread, smooth apple or orange juice|
|Main meals||Soup, white bread and butter or spread, white fish, mince, mashed potatoes, soft pasta, mousse, custard or milky puddings, bananas or fruit compotes|
|Snacks||Jelly, mousse, yoghurt (no pips), chocolate (without nuts or dried fruit), crème caramel, bagel with soft cheese|
Always check with your dietitian or medical team if you are unsure of what type of diet you should be on.
link to? https://pancreaticcanceraction.org/about-pancreatic-cancer/diet-and-nutrition/diet-surgery-pancreatic-cancer/
Going to the toilet
You will have a tube (catheter) fitted during the operation that goes into your bladder to drain out any urine. This will be taken out once you are able to get out of bed to use the toilet. It may take a few days before your bowels start working and when they do, you may have diarrhoea at first.