The Whipple procedure (also known as pancreaticoduodenectomy) is the most common operation for pancreatic cancer. It's also used to treat patients with tumors and cancers of the duodenum, ampulla of Vater and the bile duct, and chronic pancreatitis.
The surgery involves the removal of the head of the pancreas, most of the duodenum (a part of the small intestine), the gallbladder, a portion of the bile duct and sometimes a portion of the stomach. A piece of the small intestine is then attached to the bile duct, pancreas and stomach to allow you to eat normally after surgery.
Whipple: A Highly Specialized Procedure
Whipple surgery is a complex surgery that requires great expertise on the part of the surgeon.
A study published in the Annals of Surgery suggests that institutions should perform a minimum of 11 Whipple procedures annually to maintain the team's level of expertise and skills required by this complex surgery.
At UVA, our surgeons perform more than 50 Whipple procedures per year — five times that benchmark.
Who Should Have Whipple Surgery?
Whipple surgery is for patients who have removable tumors. Your doctor will use a number of tests and procedures to determine whether or not your tumor can be removed.
Benefits of Whipple Surgery
Whipple surgery is the only surgery that has the potential to cure pancreatic head cancer.
How Whipple Surgery Works
Whipple surgery can be stressful to your body. If you are weak or malnourished prior to surgery, your doctors may need to start you on a program to improve your nutritional status and strength.
You'll be given a general anesthetic for the operation. The procedure is done through an incision. Typically, recovery occurs in a regular hospital room, but some patients may need care in an intensive care setting. Your intestine needs time to recover and begin functioning again; you'll stay in the hospital until this occurs, typically around 7 days. If you have any complications after the procedure, your stay could be longer.
Large studies show that about 30% of patients having pancreaticoduodenectomy experience complications after surgery. However, many of them are minor, such as wound infections. The risk of dying after the operation is low (2% or less). Other possible complications include:
- Bleeding — Most patients don't require a blood transfusion.
- Delayed stomach emptying — About 15% to 20% of patients who have had Whipple surgery experience this complication. This involves liquids and solids remaining in the stomach for an abnormally long period of time after eating or drinking. This can usually be treated with medications. In some cases, patients may need a temporary feeding tube until their stomach function returns.
- Pancreatic leak — This complication occurs when pancreatic juice leaks from the site where the pancreas and intestine are reconnected. If this occurs, it can usually be managed with a small drain placed by our radiologists.
Pancreatic cancer is a very difficult disease to treat. Even with potentially curative surgery, the five-year survival rate is low; only about 20% of people who undergo resection (removal of tumor) are alive five years after diagnosis. To improve these outcomes, we and other programs are actively involved in developing new treatment therapies.
Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.