Surgery Overview 
The Whipple procedure is named after Albert Whipple and started in the 1930s. Today it is a relatively safe surgery that removes a pancreatic tumor and surrounding affected tissue.
After an incision is made in your belly, the surgeon will view the pancreas and other organs in the area, including lymph nodes, to see if the cancer has metastasized or spread to remaining organs. Tissue samples will be taken for a biopsy.
When the surgeon believes that the tumor has not spread and is confident it can be completely removed, he removes the part of the pancreas containing the tumor and any surrounding contaminated tissue cancer cells. Further, the surgeon will remove parts of the small intestine, the bile duct, the gallbladder, and nearby lymph nodes. Occasionally a portion of the stomach may also be removed. After removal, the remaining pancreas, bile duct and the intestine is sutured back into the intestine to direct the gastrointestinal secretions back into the gut.
The goal of surgery is to remove the tumor and some of the normal tissue around it. The normal tissue is examined under a microscope to see if it is free of cancer cells. This is known as getting “clear margins.” Having clear margins improves the chances—but doesn’t guarantee—that all cancer cells have been removed.
The second part of the surgery involves sewing your digestive tract back together.
Sometimes this operation can be done with laparoscopic surgery, using several small incisions instead of one large one.
What To Expect After Surgery
When a patient undergoes The Whipple surgery, the procedure requires general anesthesia and a hospital stay of up to one to two weeks.
If your surgeon performs laparoscopic surgery, the scar on the belly will not be as large as if it was a traditional surgery. You may feel pain and soreness in the area for about the first week after surgery. You’ll will be prescribed medication for pain mangement.
Most patients return to work or their normal routine in about 1 month. It may take about 3 months until your strength is back to normal.
After surgery, you may need more cancer treatments, such as chemotherapy and radiation. However, that depends upon your oncologist’s treatment plan and surgical success.
The function of the pancreas is to makes insulin and digestive enzymes that help digest food properly. After part or all of your pancreas is removed, most patients are prescribed medication to regulate their blood sugar. You may also need to add enzyme supplements to your diet to help digestion.
Follow up care is very important. Please make sure you follow your doctor’s instructions after surgery and post-op care.
Why It Is Done
The Whipple procedure is a surgical procedure to remove cancerous tumors from the pancreas. A Whipple operation is performed for
- cancer of the head of the pancreas
- cancer of the duodenum
- cholangiocarcinoma (cancer of the the bottom end of the bile)
- cancer of the ampulla – an area where the bile and pancreatic duct enter into the duodenum.
- whipple operation may also sometimes be performed for patients with benign (non-cancerous) disorders such as chronic pancreatitis and benign tumors of the head of the pancreas.
How Well It Works
According to recent studies, the overall survival after the whipple operation for pancreatic adenocarcinoma is about 20% at five years after surgery. Patients without spread of cancer into their lymph nodes may have up to a 40% survival. Candidates for The Whipple surgical procedure are patients with benign or low grade cancers of the pancreas. The success of any surgical outcome relies on many factors that include the health of the patient, the stage of the cancer, and the treatment approach by the oncologist.
Risks
The Whipple operation is a complex operation with a high chance of developing complications if the surgeon performing the surgical procedure has limited experience in this operation. In the hands of surgeons at Desert West Surgery who are experienced with this surgical operation the complication rate is usually very low.
The problems and complications that may be seen after this operation include:
- Pancreatic fistula: After the tumor is removed from the pancreas, the remaining organ is sutured back into to the intestine so that pancreatic juices can go back into the intestine. The pancreas is a very soft organ and in some patients this suture line may not heal very well or may take a longer than usual time to heal properly. If this happens then patients develop leakage of pancreatic juice. Usually the surgeon leaves behind a drainage catheter in the abdomen during the surgery. Any leakage of pancreatic juice after the surgery is usually removed from the body by this drainage catheter. In most patients who develop leakage of pancreatic juice after the surgery, the leakage heals on its own. It is uncommon for patients to be re-operated for this complication.
- Gastroparesis ( paralysis of the stomach): The first five to six days after the surgery, you will be provided with intravenous fluids until your bowel function returns. After your bowel function has returned your surgeon will start you on a diet of clear liquids and your diet will progress to a regular diet as you tolerate it.
References
Whipple Procedure: Effects, Success Rate, and More – WebMD www.webmd.com/cancer/pancreatic-cancer/whipple–procedure
Whipple procedure (pancreaticoduodenectomy) – Pancreatic Cancer …https://www.pancan.org/…/surgery/whipple–procedure-pancreaticoduodenectomy/
Whipple operation/surgery – USC Department of Surgery www.surgery.usc.edu/divisions/tumor/pancreasdiseases/…/whipple%20operation.html
Whipple Procedure for Pancreatic Cancer | CTCA www.cancercenter.com › Cancer › Pancreatic › Diagnostics and treatment options
Pancreatic Cancer Surgical Treatment and Whipple Procedure pancreatica.org/pancreatic-cancer/pancreatic-cancer-surgical-treatment/
Pancreaticoduodenectomy – Wikipedia https://en.wikipedia.org/wiki/Pancreaticoduodenectomy
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