Typically, the Whipple procedure is a good option for patients whose cancer is confined to the pancreas or the small area adjacent to it, and who are in good enough health to reasonably anticipate that they will fully recover.
The Whipple procedure is the most common operation to remove pancreatic cancers. You're a candidate for a Whipple procedure if your pancreatic cancer is only in the head and neck of the pancreas and hasn't spread to other organs, lymph nodes or blood vessels.
The Whipple procedure is almost always recommended for pancreatic cancer, which has 2 main types: adenocarcinoma and neuroendocrine tumors of the pancreas. It is sometimes also performed for cancers in the bile duct passing through the head of the pancreas and ending in the small intestine.
Without surgery, average life expectancy after diagnosis is about one year. Following surgery, with careful monitoring and follow-up, life expectancy may exceed two years.
While there is no age limit for the Whipple procedure, age-related issues and conditions may impact a patient's medical course and outcome.
Overall survival
The post-operation median survival ranges 10 months–33 months in patients aged 80 or over and 12 months–40 months in younger population.
If a Whipple procedure is done on the right patient for the right reason at the right time by the right surgeon, patients can expect a full return to the quality of life they had before cancer.
But a Whipple procedure is a very complex operation that often causes major changes to the digestive system. This can translate into some serious long-term effects, including abdominal discomfort, weight loss, digestive problems, and chronic fatigue.
In these instances, a PD is performed to achieve a reasonable goal, palliation, and the term palliative Whipple accurately describes the procedure.
The procedure takes 4-12 hours. Recovery in the hospital can last 7-14 days. Healing at home takes about 2 weeks. You can return to normal life after 4-6 weeks.
You may have an operation that's similar to the Whipple's, but none of the stomach is removed. This is called a pylorus-preserving pancreatoduodenectomy (PPPD). As part of your pancreas is removed, your digestion may be affected. You may need pancreatic enzyme replacement therapy (PERT) to help you digest food.
Whipple procedures are complicated because they involve so many different organs, but that's not the only reason. “The pancreas is located in a very difficult spot, deep in the central part of the abdomen,” Reddy explained.
The Whipple procedure is a major operation, and complications are possible. The most common complication is post-op leaking of pancreatic juices from the site of the incision. A drain may need to be inserted through the skin to allow for the juices to drain, perhaps for several weeks.
It is normal to lose up to 5-10% of your body weight after having a Whipple procedure. If you are continuing to lose weight exceeding 5-10% of your pre-surgery weight, consult a registered dietitian for recommendations on increasing your calorie intake.
You should be given time to recover properly from your surgery before starting chemotherapy, as you need to be well enough for six months of chemotherapy. Chemotherapy may start up to 12 weeks after your surgery.
This is a complex operation that will require hospitalization for one to two weeks with the first post-surgery night spent in the intensive care unit before being transferred to the surgical floor. Patients usually remain fatigued for about two months after this operation.
There are two common types of Whipple procedures - the conventional Whipple and the pylorus-sparing Whipple.
Problems with fat absorption
Some people have problems absorbing fat after their surgery. This may cause weight loss or make it harder for your body to absorb some vitamins. You may not be absorbing all the fats you're eating if you're having any of the following symptoms: Frequent bowel movements.
Take the pain medications whenever you need it and as instructed by your doctor. Do not do any heavy lifting or straining for at least 6 weeks after surgery. Do not lift anything over 10 pounds or 5 kg. Do not drive if you are taking pain medication because these medications can cause you be sleepy or drowsy.
For how long do I have to take creon? If you have had surgery to remove your entire pancreas or if it has been damaged by cancer, you will need to take creon for the rest of your life.
It is unusual for it to persist for more than six months post-surgery. To learn more, read the gastroparesis folder. Your stomach may empty more rapidly, leading to dumping syndrome. Symptoms of dumping syndrome can include: nausea, vomiting, abdominal pain, cramps, diarrhea, and feeling too full after meals.
Can I drink alcohol? In the first few weeks after major pancreatic surgery it is wise to be cautious and avoid alcohol. Patients with alcohol related diseases such as chronic and acute pancreatitis alcohol should be completely stopped.
The Whipple's procedure is a complex surgery performed under general anaesthesia. During the procedure, your surgeon makes an incision and removes the head of the pancreas, the gallbladder, duodenum, a part of the bile duct, and sometimes a part of the stomach.
Mayo Clinic surgeons are experts in the Whipple procedure, every variation of it and other pancreatic operations. Each year Mayo Clinic surgeons perform over 450 such surgeries.
While it is possible to live without a pancreas, doctors only recommend removing a pancreas when a person has a serious medical condition such as severe recurrent pancreatitis or pancreatic cancer.