Recovery from Whipple surgery can be challenging. The bile ducts are a system of thin tubes that carry bile from the liver and gallbladder into the small intestine to help breakdown fat from food.. The Whipple procedure is actually several procedures in one operation. For most tumors and cancers of the pancreas, the Whipple procedure is the only known cure. The location and size of your incision varies according to your surgeon's approach and your particular situation. Thiels CA, et al. In: Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. The Whipple procedure, or a pancreatico-duodenectomy, is a surgery used to treat cancer which involves the head of the pancreas. Laparoscopic vs open pancreaticoduodenectomy: Overall outcomes and severity of complications using the Accordion Severity Grading System. The surgeon will remove the head of the pancreas. What to expect from your surgery and hospital stay. Whipple procedure. OHSU Knight Cancer Institute. Compared to conventional surgery techniques, laparoscopic surgery offers many benefits, including: Contraindications are specific situations in which a surgery (or a drug or procedure) should not be performed because it could result in harm to a patient. Sometimes the Whipple procedure or other pancreas operations being performed for cancer is preceded or followed by chemotherapy, radiation therapy or both. Criteria To be considered for a Whipple procedure for pancreatic cancer (the most common condition warranting the procedure) you must have cancer of the head of the pancreas, that has not metastasized (spread) to a … Reber HA. In summary, it is best to follow these guidelines for the first 4-6 weeks after surgery. Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. The surgery involves several procedures in one operation to remove various parts of the gastrointestinal tract commonly involved in the spread of pancreatic cancer (such as the small intestine, gallbladder, and sometimes the stomach). You can expect a total stay of six to 10 days in the hospital. Prognosis After the Whipple Procedure. The gastrointestinal system will need time to recover. You will receive specific instructions from your surgical team on exactly what and when to eat. After surgery, you won’t be able to eat or drink, and the process of getting back to being able to digest food normally is often very slow. Open Access Surgery. However, this surgery is often lifesaving, particularly for people with cancer. During this procedure, surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct, the gallbladder and associated lymph nodes. You will be encouraged to take a short walk the first day following your surgery, and to increase the length of your walk each day after that. Your treatment team will talk with you and your family about how your surgery will affect your quality of life. After you are asleep, additional intravenous lines may be placed with other monitoring devices, depending on the complexity of the operation and your overall health conditions. This video is intended to help patients with the process of providing informed consent to have the Whipple procedure. Ivanics T, et al. The most important thing to keep in mind in recovery is that everyone is different. See our safety precautions in response to COVID-19. 2017;23(17):3077-3083. doi:10.3748/wjg.v23.i17.3077. The Whipple Procedure is a complex operation for the treatment of cancer arising from the head of the pancreas, bile duct, or duodenum. This is the only treatment that can lead to prolonged survival and cure for most of these tumors. Leukemia & Lymphoma Society. Journal of Surgical Oncology. When the pyloric sphincter is removed, this can increase the incidence of a condition called dumping syndrome, when food moves too quickly into the small intestine from the stomach, causing nausea, abdominal cramps, and diarrhea. Options include: A Whipple procedure may be a treatment option for people whose pancreas, duodenum or bile duct is affected by cancer or other disorder. Video by Dr Ilya Gotsadze. The reconstruction phase of the Whipple procedure involves reconnecting portions of the gastrointestinal tract, including:. Before your surgery, an intravenous (IV) line is put into a vein, usually in your arm. The Whipple procedure (also called a pancreaticoduodenectomy) is the primary surgical treatment for pancreatic cancer that occurs within the head of the gland. MD . Allscripts EPSi. ... To request an in-person or video visit appointment, please use our secure online form or call 1-855-702-8222. But for those patients whose cancer is localized, surgery may be used to remove the tumor and prevent further spread. 2016;20:891. 2016;160:1080. Barbara Woodward Lips Patient Education Center. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Risk by indication for pancreaticoduodenectomy in patients 80 years and older: A study from the American College of Surgeons National Surgical Quality Improvement Program. You may require some additional medical tests and optimization of some of your health conditions before proceeding to surgery. Editor Damian Skrabaka. Most of the duodenum is removed in the Whipple procedure. A Whipple procedure (pancreaticoduodenectomy) may be necessary to treat cancer of the pancreas, chronic (long-term) pancreatitis, cholangiocarcinoma (a cancer in the bile duct), and more. A Whipple procedure (pancreaticoduodenectomy) is a complex surgery involving several procedures during one operation. The contraindications for a Whipple procedure include: Determining if a person is eligible for a Whipple procedure is not an easy undertaking, regardless of imaging testing using very advanced technology and sophisticated equipment. Total laparoscopic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: Oncologic advantages over open approaches? Information for patients and family. So, the primary benefit of having a Whipple procedure is that with early screening and diagnosis, it can give people a chance to live for many years in relatively good health. Biliary system anatomy and function. It usually takes two or more months to recover from such an operation, to reestablish one’s ability to digest food, regain the weight that is commonly lost, and overcome the fatigue and stress that often occur after this type of surgery.. However Whipple disease was named for a different Dr Whipple! Updated 2018. Dr. Lillemoe had moved to Boston by then, so he referred me to Dr. Michael House, a surgeon at Indiana University Health. The standard Whipple procedure is an open surgery done under general anesthesia. View the video. In fact, according to the Pancreatic Cancer Action Network, any surgeon who is making a recommendation for a Whipple procedure should have significant experience performing pancreatic surgery: look for a high-volume surgeon who performs at least 15 such procedures each year.. Whipple procedure. University of Chicago Medicine Comprehensive Cancer Center. “Traditionally, this procedure is performed by conventional open surgery and more recently, by the laparoscopic approach,” said Aaron R. Sasson, MD, Chief, Surgical Oncology, at Stony Brook University Cancer Center, who has performed more than 500 Whipple resections throughout his career. What is the Whipple surgery/procedure? Illustration of the six-step pancreaticoduodenectomy (Whipple operation) as described in a number of recent text books by Dr. Evans. Updates on Drugs, news, journals, 1000s of videos, national and international events, product-launches and much more...Latest drugs in India, drugs, drugs update, drugs update He or she will also assess your condition and ensure that you are healthy enough for a complex operation. Memorial Sloan Kettering Cancer Center. In: Netter's Surgical Anatomy and Approaches. For more details, see our Privacy Policy. Whipple surgery is done using general anesthesia, so you'll be asleep and unaware during the operation. It is also used for the treatment of pancreatic or duodenal trauma, or chronic pancreatitis. Preoperative modified FOLFIRINOX treatment followed by Capecitabine-based chemoradiation for borderline resectable pancreatic cancer: Alliance for Clinical Trials in Oncology Trial A021101. About your Whipple procedure. 2016;151:e161137. Although the head of the pancreas is removed during a Whipple procedure, there is normally enough of the organ remaining (the two other portions) to produce the necessary digestive enzymes (such as lipase and amylase) and hormones (insulin and glucagon) that regulate blood sugar.. Whipple surgery effectively reorganizes the body’s digestive system. Because the … The Whipple procedure takes into account the involvement of these organs, and the surgeon makes decisions based on the spread of the malignancy. The Whipple’s procedure (or pancreaticoduodenectomy, [‘PD’]) is the most common type of surgery to remove pancreatic tumours.The procedure involves removal of the “head” (wide part) of the pancreas next to the first part of the small intestine (duodenum). Whipple’s procedure (pancreaticoduodenectomy or PD) The Whipple’s procedure is an operation. Make a donation. Pancreatic cancer has one of the poorest prognoses when compared to other common cancer types. Pain management will begin with the use of a pain pump, designed so that you can self-administer pain medication; when you begin eating solid food, you will be given oral (by mouth) pain medication. 2016;9:51-63 doi:10.2147/OAS.S99636. During the performance of the Whipple Procedure, the head of the pancreas, duodenum, and common bile duct are removed (resected) and reconstructed as described in the videos below. The duodenum, the first segment of the small intestine, is responsible for accepting the food you eat (from the stomach) and moving nutrients into the lower segments of the small intestine. drugsupdate.com - India's leading online platform for Doctors and health care professionals. The pancreas is a vital organ that lies in the upper abdomen, behind your stomach. Before being admitted to the hospital, talk to your family or friends about your hospital stay and discuss any help you may need from them when you return home. Talk with your doctor about concerns you may have about your surgery and various other treatment options either before or after your operation. Pancreaticoduodenectomy. In spite of the fact that 20% of those with pancreatic cancer should be eligible for a Whipple procedure, nearly half of those who should be deemed eligible are informed that surgery is contraindicated for them. Therefore, it’s very important to seek out a health care professional who specializes in performing pancreatic surgery. Pancreatic cancer. Accessed Feb. 22, 2017. You will be discharged with a prescription for oral pain medication. In some instances, a person may undergo a type of modified Whipple procedure that preserves the pyloric valve (also called the pyloric sphincter). It is a part of the stomach that allows food to empty from the stomach into the duodenum. Small cell carcinoma of the pancreas: A surgical disease. A fever (higher than 100 degrees Fahrenheit), Pain or redness of the incision that worsens (instead of lessening) with time, Redness of the incision site that spreads, Pain that does not respond to taking prescribed pain medications, Constipation (specifically, an absence of having a bowel movement for more than three days), Frequent bowel movements, severe diarrhea, or oily stools, A sudden increase in blood or fluid from your drainage tube, A special diet, limiting foods such as fried, greasy, highly processed, and sugary foods (depending on a person’s personal food tolerances), Daily medication to help lower stomach acid, Medication to lower blood sugar (if you require long-term blood sugar control). Whipple procedure. At that point in time, the planned Whipple procedure will not be performed. Croome KP, et al. The head of the pancreas attaches to the first part of the small intestine (called the duodenum). Douglas A. Nelson, MD, is double board-certified in medical oncology and hematology. The Whipple procedure, or a pancreatico-duodenectomy, is a surgery used to treat cancer which involves the head of the pancreas. Talk to your treatment team, family and friends if you feel stressed, worried or depressed. Playdough Surgery - Pylorus-Preserving Pancreaticoduodenectomy AKA Whipple Procedure - Part I . This can occur after a Whipple surgery due to the pancreas producing less insulin. Mayo Clinic facts about coronavirus disease 2019 (COVID-19), Our COVID-19 patient and visitor guidelines, plus trusted health information, Mayo Clinic Health System patient vaccination updates, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, See our safety precautions in response to COVID-19, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter — Digital Edition, FREE book offer — Mayo Clinic Health Letter, Time running out - 40% off Online Mayo Clinic Diet ends soon. You may also receive some medication to help you relax if you are nervous. The Whipple procedure is not contraindicated in adults over the age of 75. AskMayoExpert. A Whipple procedure (pancreaticoduodenectomy) may be necessary to treat cancer of the pancreas, chronic (long-term) pancreatitis, cholangiocarcinoma (a cancer in the bile duct), and more. It works closely with the liver and ducts that carry bile. Prognosis After the Whipple Procedure. Journal of the American College of Surgeons. Medical University of South Carolina (MUSC). Pancreas. Accessed. Spleen Preserving Radical Gastrectomy with D2... Ilya Gotsadze views: 2883 . It is one of the most common types of surgery for pancreatic cancer. The Whipple procedure, or a pancreatico-duodenectomy, is a surgery used to treat cancer which involves the head of the pancreas. Complications of the Whipple procedure. Your surgeon will review several factors to evaluate which approach to your surgery is best in your situation. Your surgeon then reconnects the remaining parts of your pancreas, stomach and intestines to allow you to digest food normally. The digestive system is then rebuilt in a manner which allows normal digestion. Townsend CM Jr, et al. Nurses and staff members will confirm your name, date of birth, procedure and surgeon. 5th ed. You will have several drainage tubes located at the site of your surgical incision that will remove fluid from the site; you will probably be discharged with the drains in place, and your discharge nurse will give you instructions on specific wound care at home.