Allen Oldfather Whipple, an American surgeon, originated an experimental procedure to treat pancreatic cancer. A pancreaticoduodenectomy is the name of the operation also referred to as a Whipple procedure. The Whipple procedure involves removing a portion of the pancreas and surrounding organs while reconnecting the stomach to the small intestines. Pancreatic cancer is an aggressive form of cancer and only a few individuals affected are candidates for surgery.
Surgical Summary
A Whipple procedure includes the removal of the cancerous portion of the pancreas. The surgery also includes removing the gallbladder, the duodenum and a section of the bile duct. Depending on the severity of the cancer, the surgery may include removal of the lower section of the stomach. The Whipple procedure is used to cure localized pancreatic cancer and as palliative care for incurable pancreatic cancer.
Candidates
Individuals with a localized, nonmetastasized tumor in the head or the tail of the pancreas make the best candidates for a Whipple procedure. The cancerous tumor needs to be contained in the head or tail of the pancreas. According to the American Cancer Society, approximately 10 percent of patients with pancreatic cancer are candidates for this surgery.
The Whipple Procedure
After placing the individual under general anesthesia, the surgeon begins the Whipple procedure. A midline incision helps to visualize the pancreas. Alternatively, suregeons perform the surgery with laparoscopic equipment to minimize scarring and risk of infection. If the tumor looks operable, the surgeon begins the removal of the lower stomach. This step disconnects the stomach from the small intestine, where the pancreas connects. The removal of the head of the pancreas is the next step in the surgery. The portion of the small intestine, with the pancreas head, is the next section removed from the body. This step also removes the gallbladder and bile duct. Finally, the surgeon attaches the remaining bile duct and pancreas to the small intestine and stomach. The placements of temporary drainage tubes help avoid nausea and vomiting. A feeding tube in the lower intestine supplies nutrition until the surgical area heals.
Complications
According to the American Cancer Society, the outcome of the surgery depends on the skill of the surgeon. Surgeons who perform the Whipple procedure more routinely have lower complication rates after the operation. Do research to find the best surgeon before undergoing surgery. Common complications from the Whipple procedure include bleeding, gastrointestinal upset, short-term diabetes and infection.
When to Call the Doctor
After the Whipple procedure, call the doctor if you experience a fever or for additional signs of an infection. A warm, red drainage and a tender or painful surgical incision indicates an infection. In addition, report increased pain in the abdomen.
Recovery
The recovery from a Whipple procedure is long and difficult. The normal hospital stay after a Whipple is about a week to three weeks. According to the American Cancer Society, the post-Whipple procedure five-year survival rate is about 20 percent. Slowly increase the diet as tolerated, but avoid sugary or sweet foods. The surgery causes pain and may cause fatigue for the individual, so the return to normal daily activities can take a month or more after the operation.
