Surgery for small intestine cancer

Surgery is a medical procedure to examine, remove or repair tissue. Surgery, as a treatment for cancer, means removing the tumour or cancerous tissue from your body.

Most people with localized small intestine adenocarcinoma will have surgery. The type of surgery you have depends mainly on where the tumour is in the small intestine and whether or not it is resectable (it can be completely removed with surgery). When planning surgery, your healthcare team will also consider other factors, such as your overall health and if you have any medical problems.

Surgery may be the only treatment you have or it may be used along with other cancer treatments. You may have surgery to:

• completely remove the tumour
• reduce pain or ease symptoms (called palliative treatment)
• repair a hole in the small intestine (called a bowel perforation)

The following are the types of surgery used to treat small intestine adenocarcinoma.

Different types of bowel resection may be used to treat small intestine tumours.

A segmental small bowel resection (also called segmental small intestine resection) is surgery to remove part of the small intestine. Some of the mesentery (a fold of tissue that supports the small intestine) and lymph nodes in the area may also be removed.

Sometimes a tumour can cause a bowel perforation. A segmental bowel resection is used to repair the hole in the small intestine.

A right hemicolectomy (also called a partial colectomy) removes the right side of the colon (called the ascending colon). The small intestine is then attached to the remaining part of the colon.

You may need a right hemicolectomy if the tumour is close to the colon or where the small intestine joins the colon.

Find out more about bowel resection.

The Whipple procedure is also called pancreaticoduodenectomy. It removes part of the pancreas and lymph nodes close to it, parts of or the entire duodenum, the gallbladder and part of the common bile duct. It may also remove the lower part of the stomach (called the pylorus).

This surgery may be used to remove tumours in the upper, or proximal, part of the duodenum that is close to the stomach. It may also be used to remove tumours in the area where the ducts from the pancreas and liver enter the duodenum (called the ampulla of Vater).

The Whipple procedure is a complex surgery that can have serious complications. It is done by a very experienced surgeon at a hospital or centre that does many of these surgeries.

Find out more about the Whipple procedure.

Palliative surgery is used to relieve pain and other symptoms caused by a small intestine tumour. It is done when a tumour is unresectable (it can't be completely removed with surgery). It is also done if a tumour blocks the small intestine (called a bowel obstruction).

The surgeon may do a surgical bypass to allow digested food and fluid to go around, or bypass, a tumour in the small intestine. In some cases, the surgeon may remove part of the tumour. Another way the surgeon can create a bypass is by putting a small tube (called a stent) through the tumour.

Side effects of surgery will depend mainly on the type of surgery and your overall health. Tell your healthcare team if you have side effects that you think are from surgery. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Surgery for small intestine cancer may cause short bowel syndrome. This condition happens when there is not enough intestine to properly absorb water and nutrients from foods. Surgery may also cause these side effects:

• dumping syndrome
• diarrhea
• bleeding
• pain in the area of the surgery
• constipation
• infection
• leaking from where the 2 ends of the intestine were joined (called an anastomotic leak)

Find out more about surgery and side effects of surgery. To make the decisions that are right for you, ask your healthcare team questions about surgery.