Pancreatic Cancer

• How do you manage pancreatic cancer?

  • Non-surgical: Chemo & radiation = ineffective; use as adjunctive tx only  
  • Discuss advance directives (median survival 4 – 6 mo d/t mets) 
  • Surgical: Whipple Procedure (Pancreaticoduodenectomy) 
  • Prognosis w/ surgery = 5 yrs; mean life expectancy 15 mo 
• What are nursing dx to consider in post-op care of a patient undergoing a Whipple Procedure?


  • Fluid Imbalance d/t third spacing  
  • Risk for peritonitis 
  • Nutrition less than body requirements 
  • Other: prevent atelectasis, manage pain, psychosocial needs 
• How does the nurse manage risk for peritonitis post-op whipple procedure?

  Assess abdomen; Maintain NGT patency

  do not manipulate!
• What are potential complications that may arise in a patient post-op Whipple procedure experiencing nutrition less than body requirements?

  • Dumping Syndrome 
  • Depending on if pylorus preserved will have delayed gastric emptying or dumping syndrome  
  • Hyperglycemia d/t loss of beta cells  
  • Hypoglycemia d/t impaired release of glucagon  
• What are some nutrition teaching post-op whipple procedure?

  • May be 10 days – 6 weeks before oral feedings 
  • Pancreatic enzymes, supplements and low fat, low protein, moderate carbs w/ small frequent meals