Whipple Procedure, Pancreatitis, Pancreatic Cancer, Pancreas Surgery
Whipple Procedure- What is it? When it is done? Which organs are removed? Complications & Post Surgery Care
Learn about Whipple Procedure. What it is and why is it performed.
Summary: 60 Seconds Read
What is Whipple Procedure?
A Whipple procedure- also known as a pancreaticoduodenectomy- is a complex operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct.
The Whipple procedure is used to treat tumors and other disorders of the pancreas, intestine and bile duct. It is the most often used surgery to treat pancreatic cancer that's confined to the head of the pancreas. After performing the Whipple procedure, your surgeon reconnects the remaining organs to allow you to digest food normally after surgery.
The Whipple procedure is a difficult and demanding operation and can have serious risks. However, this surgery is often lifesaving, particularly for people with cancer.
Related procedures
Depending on your situation, your doctor may talk with you about other pancreatic operations. Seek a second opinion from a specialized surgeon if needed. Options include:
- Surgery for tumors or disorders in the body and tail of the pancreas. Surgery to remove the left side (body and tail) of the pancreas is called a distal pancreatectomy. With this procedure, your surgeon may also need to remove your spleen.
- Surgery to remove the entire pancreas. This is called total pancreatectomy. You can live relatively normally without a pancreas but will need lifelong insulin and enzyme replacement.
- Surgery for tumors affecting nearby blood vessels. Many people are not considered eligible for the Whipple procedure or other pancreatic surgeries if their tumors involve nearby blood vessels. The procedures involve also removing and reconstructing parts of blood vessels.
When is Whipple Procedure performed?
A Whipple procedure may be a treatment option for people whose pancreas, duodenum or bile duct is affected by cancer or other disorder. The pancreas is a vital organ that lies in the upper abdomen, behind your stomach. It works closely with the liver and ducts that carry bile. The pancreas releases (secretes) enzymes that help you digest food, especially fats and protein. The pancreas also secretes hormones that help manage your blood sugar.
Your doctor may recommend you have a Whipple procedure to treat:
- Pancreatic cancer
- Pancreatic cysts
- Pancreatic tumors
- Pancreatitis
- Ampullary cancer
- Bile duct cancer
- Neuroendocrine tumors
- Small bowel cancer
- Trauma to the pancreas or small intestine
- Other tumors or disorders involving the pancreas, duodenum or bile ducts
The goal of doing a Whipple procedure for cancer is to remove the tumor and prevent it from growing and spreading to other organs. This is the only treatment that can lead to prolonged survival and cure for most of these tumors.
Which organs are removed during Whipple Procedure?
During this procedure, surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct, the gallbladder and associated lymph nodes. In some cases, the surgeon may remove the body of the pancreas, the entire duodenum and a portion of the stomach.
What are the Complications of Whipple Procedure?
Immediately after the Whipple procedure, serious complications can affect many patients. One of the most common of these include the development of false channels (fistulas) and leakage from the site of the bowel reconnection. Other possible surgical complications include:
- Infections
- Bleeding
- Trouble with the stomach emptying itself after meals
After surgery, patients are usually hospitalized for a week before returning home. Because recovery can be slow and painful, they usually need to take prescription or over-the-counter pain medications.
At first, patients can eat only small amounts of easily digestible food. They may need to take pancreatic enzymes- either short-term or long-term- to assist with digestion. Diarrhea is a common problem during the two or three months it usually takes for the rearranged digestive tract to fully recover.
Other possible complications include:
- Weight loss. Most patients can expect to lose weight after the surgery.
- Diabetes.This condition can develop if too many insulin-producing cells are removed from the pancreas. However, patients who have normal blood sugar before surgery are unlikely to develop diabetes, and those who recently developed diabetes before surgery are even likely to improve.
Post Surgery Care
After your Whipple procedure, you can expect to:
- Stay in the general surgical unit. Most people will go directly to a general surgical nursing floor after surgery to recover. Nursing staff and the entire surgical team will be monitoring your progress several times a day and watching for any signs of infection or complications. Your diet will be slowly advanced as tolerated. Most people will be walking immediately after the operation. Expect to spend at least a week in the hospital, depending on your overall recovery.
- Stay in the intensive care unit (ICU) for a few days. If you have certain medical conditions or a complex case, you may be admitted to the ICU after surgery. ICU doctors and nurses will monitor your condition continuously to watch for signs of complications. They'll give you fluids, nutrition and medications through intravenous (IV) lines. Other tubes will drain urine from your bladder and drain fluid and blood from the surgical area.
After discharge from the hospital, most people can return directly home to continue recovery. Some people are asked to stay nearby for several days for monitoring and follow-up visits. Older adults and people with significant health concerns may require a temporary stay in a skilled rehabilitation facility. Talk to your surgeon and team if you are concerned about your home recovery.
Most people are able to return to their usual activities four to six weeks after surgery. How long it takes you to recover may depend on your physical condition before your surgery and the complexity of your operation.
