The Whipple procedure is an operation to remove a pancreatic tumor and a lot of the tissue around it.
After a large cut is made in your belly, the surgeon will look at the pancreas and other organs in the area, including lymph nodes, to see if the cancer has spread. Tissue samples will be taken for a biopsy.
When the surgeon is satisfied that the tumor has not spread and can be removed entirely, he or she takes out the part of the pancreas containing the tumor. The surgeon will also take out the first part of the small intestine, the bile duct, the gallbladder, and nearby lymph nodes. Sometimes the lower part of the stomach is also removed.
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 chancesâ€”but doesn't guaranteeâ€”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
The Whipple procedure requires general anesthesia and a hospital stay of 1 to 2 weeks.
Unless you had laparoscopic surgery, you will have a large scar in your belly. It's normal to feel pain in the area for the first week or so. You'll get medicines to control the pain.
You will probably be able to return to work or your normal routine in about 1 month. It will probably take about 3 months until your strength is back to normal.
After surgery, you may need more treatment, such as radiation or chemotherapy, that can help you live longer.
The pancreas makes insulin and digestive enzymes that your body needs to digest food properly. After part or all of your pancreas is removed, you may need to take medicine to regulate your blood sugar. You may also need enzyme supplements to help your body digest food.
It's important to receive follow-up care. Your doctor will set up a schedule of checkups and tests.
Why It Is Done
The Whipple procedure is done to try to remove cancer from the pancreas.
How Well It Works
People who have this surgery live for an average of 18 months.footnote 1 This means that some people live longer than that.
In fact, when the tumor is removed with clear margins, 20 out of every 100 patients live at least 5 years.footnote 1
Unfortunately, even with clear margins, pancreatic cancer eventually comes back most of the time.
The Whipple procedure is one of the most complicated operations a surgeon can do. It carries a fairly high risk of complications, such as:
Trouble with the stomach emptying after eating.
Leaking at the connections the surgeon makes.
Infection or bleeding.
A small number of people don't survive this operation. When surgeons with a lot of experience perform this surgery, fewer than 5 out of 100 patients die, compared to 20 to 30 out of 100 when the surgeon is less experienced.footnote 1 So it's important to find a surgeon who has done the Whipple procedure many times.
What To Think About
CT scans and other imaging tests help your doctor know whether this surgery could work for you.
Doherty GM, Way LW (2010). Pancreas. In GM Doherty, ed., Current Diagnosis and Treatment: Surgery, 13th ed., pp. 591â€“592. New York: McGraw-Hill.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineKathleen Romito, MD - Family Medicine