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Whipple Surgery for Pancreatic Cancer

What is Whipple Surgery?

The Whipple procedure, also known as pancreaticoduodenectomy, is the most common surgery that removes tumors from the pancreas.

It's a complex treatment where surgeons first remove part of the pancreas and GI tract. They then rebuild and reroute the pancreas to the small intestine.

The goal is to remove the tumor to prevent it from growing and spreading cancer to other organs.

Types of Whipple surgery

  • Open surgery – one large incision.
  • Robotic surgery – a few small cuts for a camera and the surgeon's tools, which he or she controls with computer technology.

Your surgeon will work with you to choose what's best for you.

Whipple Surgery Benefits

Whipple surgery:

  • Gives people the best long-term survival rates from pancreatic tumors.
  • Is the only cure for pancreatic cancer.
  • Improves symptoms like pain, jaundice, and digestive problems.

Whipple Surgery Risks and Complications

Risks include:

  • Bleeding and infection.
  • Delayed stomach emptying.
  • Trouble keeping food down.
  • Leaks from the pancreas or bile duct connections.
  • Short- or long-term diabetes.
  • Long, difficult recovery times.

Possible complications of Whipple surgery include:

  • Weight loss.
  • Infection in the lungs, bladder, or incision site.
  • Blood clots.
  • Stomach ulcers or other digestive problems.

Who's a Candidate for Whipple Surgery?

One in five people with pancreatic cancer can typically have Whipple surgery.

To qualify, your:

  • Tumor must be in the head of the pancreas.
  • Cancer must not have spread to other parts of your body.

To see if surgery is right for you, speak with a surgeon who does a high volume of Whipple procedures.

The Pancreatic Cancer Action Network advises that you always seek a second opinion and that you choose a hospital that performs a high volume of Whipple surgeries each year.

Conditions We Treat With Whipple Surgery

  • Pancreatic tumors and cysts
  • Neuroendocrine tumors
  • Pancreatitis
  • Bile duct cancer
  • Ampullary cancer
  • Small bowel cancer
  • Trauma to the pancreas

What to Expect Before, During, and After Whipple Surgery

Your care team will give you instructions on how to prep for surgery.

They'll also tell you what to expect during and after the procedure.

Before Whipple surgery: How to prepare

Before surgery, you:

  • Might need treatment to shrink the tumor to increase the odds of the Whipple's success. This often involves a mix of chemotherapy and radiation.
  • Might need further testing, depending on your age and any other health problems you have.
  • Will likely need to stop eating, drinking, and taking certain drugs the night before surgery.

On the morning of surgery, after you check into the hospital:

  • A nurse will insert an IV to give you medicine and fluids.
  • You may need an epidural catheter or spinal nerve block. These help reduce pain as you recover the first few days after surgery.

During Whipple surgery: What to expect

Based on the type of surgery you have, it may take four to 12 hours.

During the Whipple procedure, your surgeon removes the:

  1. Head of the pancreas and lower end of the stomach, first.
  2. Duodenum, the first part of the small intestine.
  3. Gall bladder, part of the bile duct, and surrounding lymph nodes.

The surgeon then joins the:

  • Remaining parts of the stomach and bile duct to the small intestine.
  • Pancreas to the small intestine or stomach.

After Whipple surgery: How to recover

After surgery, you'll likely stay on a surgical floor. If you have other health conditions or a complicated surgery, you might stay in the ICU.

Your nurses and doctor will watch you closely for post-op problems or infections.

You won't eat anything by mouth for a few days while your digestive system heals. But you will be up and walking short distances on the first day after surgery.

You'll likely have a pain pump to manage any pain.

Your doctors will also run tests to see if all the cancer is gone and make sure your lymph nodes are cancer-free.

After one to two weeks healing in the hospital, you'll head home.

Home recovery can be lengthy, so you'll need someone to help care for you.

For the first four to six weeks, you may not drive or return to your daily routine.

Most people take six to nine months to heal fully. Others will need a year before they're back to feeling normal.

Some people also need adjuvant therapy after surgery. This may include chemo, radiation, or both. It will help destroy any small cancer cells left after surgery.

After Whipple surgery, you may need to:

  • Adjust your diet to help reduce stomach problems like gas, pain, or diarrhea.
  • Eat small meals.
  • Avoid greasy or fatty foods.

Life Expectancy After Whipple Surgery

The five-year survival rate for Whipple surgery is 20% to 25%.

While the surgery is complicated, it's the only known cure for pancreatic cancer and offers many people hope for a full recovery.

Read stories from patients who've had Whipple surgery on the Pancreas Foundation's website.

Discover the benefits of choosing UPMC Hillman for your pancreatic cancer care.