What is a Whipple procedure?
The Whipple procedure, also known as a pancreaticoduodenectomy, is a cancer treatment that involves removing the head of the pancreas, the duodenum, the gallbladder and bile duct.
This is a very complex, risky procedure and only performed in the most severe cases. The goal is to completely remove the tumor to prevent it from spreading to other areas of the body. For many of the cancers it treats, this is the only option for long-term survival.
Who is a candidate for a Whipple procedure/pancreaticoduodenectomy
Typically, the Whipple procedure can be performed for patients who have any of the following cancers:
The procedure can be used to treat other, non-cancerous conditions such as:
- Pancreatic cysts or other pancreatic tumors
- Trauma to the pancreas or small intestine
Your doctor will evaluate your case to determine if you are a candidate for the Whipple procedure or if there are other less invasive treatments that may be effective.
Risks of a Whipple procedure/pancreaticoduodenectomy
The Whipple procedure is a complicated surgery. Risks associated with the procedure include:
- Severe bleeding at surgical sites
- Infection, either at the incision site or in the abdomen
- Difficulty eating due to digestion issues
- Leaking from the pancreas or bile duct connections
What to expect during a Whipple procedure/pancreaticoduodenectomy
During a Whipple procedure your surgeon will remove:
- Your gallbladder
- Head of the pancreas
- Part of your bile duct
- Portion of the small intestine
- Part of the stomach
When all of these organs are removed, the surgical team will connect the remaining portions of the organs. Because of the complexity of the procedure, this surgery will take a few hours.
A Whipple procedure can be performed in a variety of ways:
During an open pancreaticoduodenectomy, your surgeon will make a large incision in your abdomen to access the abdominal cavity. This is the most common type of pancreaticoduodenectomy.
During a laparoscopic pancreaticoduodenectomy, a minimally invasive treatment option, your surgeon will make several small incisions in the abdomen where he or she can insert surgical instruments and a camera. The surgeon will use the camera to get a better visual of the surgical area and use the instruments to perform the procedure.
Robotic pancreaticoduodenectomy is a minimally invasive procedure where your surgeon uses a robot to perform the Whipple procedure.
Your doctor will evaluate your case to determine if an open procedure or a minimally invasive procedure is most appropriate. The minimally invasive options offer quicker recovery and less blood loss, but they take longer than an open procedure — which can lead to other complications.
Recovery from a Whipple procedure/pancreaticoduodenectomy
You will be hospitalized for a week or more after a Whipple procedure. Directly after surgery you will spend a night or more in the intensive care unit (ICU) before being moved to a surgical floor for monitoring.
What you can expect in the hospital:
- You will not be able to eat for a few days
- You will be encouraged to start walking as soon as you can
- You will need a catheter to urinate
- You may not be able to have a bowel movement for many days
Once you are ready for discharge, you will be given strict care instructions for your recovery at home. Instructions may include:
- Follow-up schedule with your physician - you will likely have weekly appointments
- Other treatment options needed - if you need radiation or chemotherapy after the Whipple procedure, you will begin those treatments as soon as possible
- Wound care instructions
- How to eat post-surgery - you will gradually return to eating and will have to experiment with different foods
- Activity level - you will need to slowly rebuild your stamina to resume your activity level. You should not lift anything heavy until your doctor clears you to do so.
Call your doctor right away if you experience any of the following symptoms during recovery from a Whipple procedure:
- High fever (over 100 degrees)
- Increased pain
- No bowel movements for more than three days or frequent bowel movements
- Redness around an incision that worsens as time goes on
- Increase in fluid draining from incision site