People with pancreatic cancer may get their tumor removed with a surgery called the Whipple procedure. This inpatient, usually open surgery, often requires a week-long hospital stay and another four to six week recovery time. The procedure increases the survival rate for people with pancreatic cancer.
The Whipple procedure (also called a pancreaticoduodenectomy) is a surgery to remove a cancerous tumor from the head (right side) of your pancreas to stop it from spreading to other organs (metastasizing). Around 15% to 20% of people with pancreatic cancer are eligible for this surgery.
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Your pancreas is an important organ located in your abdomen. It’s shaped a bit like a fish. The widest part on the right is called the head. The middle section is called the neck or body, and the thin end is referred to as the tail. Your pancreas makes hormones, helps your body digest food and controls your sugar levels.
This type of cancer is caused by a growth (tumor) in your pancreas. The tumor usually grows in the head, neck or body of your pancreas. Few grow in the tail. Pancreatic cancer is primarily caused by smoking and most of those diagnosed are between the ages of 60 and 80 years.
Yearly in the U.S., about 57,000 people are diagnosed with pancreatic cancer and there are around 46,000 deaths. Only roughly 8.5% of people with this type of cancer live for another five years after their diagnosis.
The Whipple procedure is a major inpatient surgery. You’ll need to recover in the hospital for about a week.
A team of nurses, anesthesiologists and anesthetists assist your surgeon during the Whipple procedure.
If you have cancer, you may go through radiation or chemotherapy before you have the surgery.
Your surgeon will instruct you to stop taking certain medications in the days leading up to your surgery. You should also:
Once at the hospital, your nurse will insert an intravenous line (IV) into your arm to inject fluids and medications you’ll need during the surgery. Additionally, an epidural catheter or spinal injection may be necessary. They block your nerves, helping decrease pain after surgery.
The Whipple procedure is a complex operation with a high risk of major complications. It takes a lot of skill and experience to perform the surgery and manage any complications. To get the best outcome, you’ll want to have a very experienced surgeon and be in a hospital that performs at least 15-20 Whipple procedures each year.
An open surgery is one where the surgeon cuts one large opening. Minimally invasive (laparoscopic) surgery uses several smaller cuts (incisions). With a minimally invasive surgery, there’s usually less blood loss, fewer complications and a faster recovery time. Although a laparoscopic surgery is ideal for many indications, the Whipple procedure is usually an open surgery.
The Whipple procedure can be summed up in a few steps:
The Whipple procedure is a complicated surgery that takes 4-12 hours.
Yes, you will be under general anesthesia for the Whipple procedure. This treatment makes you unconscious and insensitive to pain or other stimuli.
The Whipple procedure is a significant surgery. Recovery from the procedure will take some time.
You’ll have pain for a while after your Whipple procedure. During your hospital stay, your care team will manage your pain and watch for signs of infection or other complications. You’ll be on a clear, liquid diet for a few days until your healthcare providers feel that you’re ready to introduce solid foods. As soon as you feel up to it, you should start doing lung exercises (incentive spirometry) and moving about your room — just be sure to call a nurse or physical therapist for help getting up so you don’t fall.
A Whipple procedure increases your chances of long-term survival with pancreatic cancer. Unfortunately, very few people survive pancreatic cancer. Only about 8.5% of people with pancreatic cancer live for five years. If you have the Whipple procedure, your chances increase to 25%.
A Whipple procedure is often the only hope for a cure from pancreatic cancer. However, cure rates depend on the location and stage of your tumor, as well as other individual factors. Ask your surgeon about whether they think a Whipple procedure will cure your pancreatic cancer.
As many as one-third of people who go through the Whipple procedure have complications, which include:
The survival rate for a Whipple procedure has improved a lot in the last few decades. Thirty years ago between 5% and 15% of people who went through the Whipple procedure died from complications. Now the mortality rate is about 1% to 3%.
Following surgery, you’ll recover in the hospital for about a week. During this hospital stay, your care team will monitor your pain levels and watch for complications.
It’s a major surgery and recovery will take time. If there are no complications, you should be able to resume your normal activities in about 4-6 weeks.
In the days following your Whipple procedure you’ll be on a clear, liquid diet. Your surgeon will decide when you’re ready to introduce solid foods. For a while, you will want to eat soft foods that are easy to digest. Talk to your healthcare provider about foods they recommend.
After a Whipple procedure, your surgeon will prescribe medications to help manage your pain. You may also be given medications to prevent clots in your legs.
Contact your surgical team if the following happens:
Call emergency services or go to the nearest emergency department right away if you experience any of the following problems:
A note from Cleveland Clinic
The Whipple procedure offers hope to people with pancreatic cancer. Removing the tumor can increase the quality and length of your life. Have your Whipple procedure performed by an experienced surgeon at a well-established hospital. It’s appropriate to ask your surgeon about how many times they’ve performed the procedure (try to find one who has done it 15 or more times).
Pancreatic cancer can feel like a devastating diagnosis. Fortunately, a Whipple procedure might extend your life expectancy.
Last reviewed by a Cleveland Clinic medical professional on 08/06/2021.
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