Whipple’s procedure

13. Whipples procedure blog
  • The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types.

    The Whipple procedure (pancreaticoduodenectomy) is an operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. The remaining organs are reattached to allow you to digest food normally after surgery.

  • The Whipple procedure could be performed for any of the following reasons:

    • Chronic pancreatitis
    • Pancreatic cancer (in the head of the pancreas)
    • Cancer of the initial part of small intestine (Also called duodenum)
    • Cholangiocarcinoma – (a cancer in the bile duct)

The Whipple procedure is done in the hospital using general anesthesia (you will be asleep).

The surgeon makes a large cut (incision) in your abdomen. The surgeon checks the organs and lymph nodes in the abdomen to make sure the cancer hasn’t spread and can be completely removed. Tissue samples are taken for biopsy.

The surgeon then removes the tumour, tissue around the tumour, part of the pancreas, the duodenum, the pylorus (lower part of the stomach), the gallbladder, part of the common bile duct and nearby lymph nodes.

After removing these organs, the surgeon attaches the remaining end of the stomach to the jejunum(small intestine) . The rest of the common bile duct and pancreas are also attached to the jejunum so that bile and pancreatic juices can flow into it. These juices help neutralize stomach acid and lower the risk of an ulcer in the area.

Sometimes patients receive treatment before surgery which is called neoadjuvant therapy, this is generally chemotherapy, radiation therapy, or both.

Often patients receive adjuvant therapy, or treatment that is given after surgery. The goal is to kill any small cancer cells that may still be present to prevent the tumor from coming back.

After the operation you will be shifted to an Intensive Care Unit, where your pulse & blood pressure will be closely monitored. You will be given IV fluids, pain killers & antibiotics as suggested by your doctor.

There will be a small tube passing through your nose & few tubes coming out of your tummy. You will be started on liquid diet 2-3 days after your operation. You will be allowed to take solid diet once your gut has properly recovered.

Patients typically spend 7-12 days in hospital after a whipple’s operation.

Your doctor will discuss with you about following complications:

  • Bleeding
  • Pain
  • Infection
  • Leakage from the stitches
  • Vomiting

Your chances of long-term survival after a Whipple procedure depend on your particular situation. For most tumors and cancers of the pancreas, the Whipple procedure is the only known cure.

Talk to your treatment team, family and friends if you feel stressed, worried or depressed. It may help to discuss how you’re feeling. You may want to consider joining a support group of people who have experienced a Whipple procedure or talking with a doctor.

Dr. Harsh J Shah