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Whipple Surgery For
Pancreatic Cancer

Pancreatic cancer is the deadliest form of cancer. The survival rate is the lowest of all cancer-types. The location of the cancer within the pancreas, its progression stage at time of detection, age and health of the patient and medical factors will have an impact on physician-suggested treatment options. See Pancreatic Cancer Facts and a video on the role of the pancreas.

The hope is always early detection of pancreatic cancer in its lower-grade stages when elimination is more optimistic. In more advanced stages, treatment options are most likely limited to life-extending treatments which could include a major surgery option called the Whipple Procedure.

The purpose of this article is to heighten public awareness of the Whipple Surgery option, but does not intend to replace medical advice. Well-informed decisions should always be based upon the advice of chosen physicians, surgeons and other medical experts. Studies show that the skill, experience and volume of successful Whipple Surgeries performed by the surgeon and hospital will have greater potential of positive results. So, diligent research by the patient is crucial to extended survival rates.

What Is Whipple Surgery?

Whipple surgery is often a surgical option when pancreatic cancer is found in the head of the pancreas. It involves removal of the pancreas head, most of the duodenum (small intestine), a portion of the bile duct, gallbladder, part of the jejunum and the lymph nodes located near the pancreas. Sometimes a portion of the stomach may also be removed.

After surgical removals, the remaining balance of the pancreas and bile duct is attached to the small intestine permitting bile from the liver to continue entering the small intestine. This allows the remaining parts of the pancreas, stomach and intestines to sustain the digestive process.

Risk During Whipple Surgery

The Whipple Operation is complicated major surgery with degrees of variable risk. The extreme risk is not surviving the surgery. In the 1960s and 1970s, about 25% of patients did not survive the operation. Today, with medical advancement and experience, it is a much safer operation with a significant reduction in mortality rates during surgery.

A study from Johns Hopkins and Memorial Sloan Kettering shows a correlation of survival rate versus the experience of both hospital and surgeon. Hospitals that perform a high number of Whipple operations experience a death rate of less than 4% whereas those hospitals that perform few Whipple surgeries may experience a significantly higher death rate. A study by The New England Journal of Medicine found operative mortality rates to be four times higher (16.3 percent vs. 3.8 percent) at low-volume (averaging less than one per year) hospitals versus high-volume (16 or more per year) hospitals.

Risks After Whipple Surgery

After Whipple surgery, the patient can expect a hospital stay of 10 to 14 days for recovery and protection against post-surgery risks and complications. Among those immediate risks are infection, bleeding. leaking of digestive enzymes, pancreas inflammation and possibility of other organ failure including the heart, liver and kidneys.

One of the purposes of the pancreas is producing digestive enzymes. Since pancreatic tissue is removed during surgery, diminished enzyme production could cause digestive problems. Long-term use of an oral enzyme supplementation may be necessary. Diets and eating habits typically have to change with smaller meals and in between snacks.

It takes several days after surgery for bowel functions to return. Intravenous nutrition is implemented followed by progressive stages of diet from liquids to an eventual regular diet as normal function gradually returns. There is about a 25% chance the stomach may be temporarily paralyzed for several weeks. Anticipating these cases, the surgeon will place a feeding tube into the intestine at time of surgery that will remain until normal stomach function returns.

Developing diabetes is a risk. One of the roles of the pancreas is producing insulin to control blood sugar. Since pancreas tissue is removed during surgery, the remaining parts of the pancreas may not produce enough insulin creating the risk of developing diabetes. Patients that have no diabetic history have a low probability of developing diabetes. If the patient has diabetes, it can become more severe after surgery.

Summary

The Whipple Operation does not cure pancreatic cancer. It is an option that has been positively demonstrated to extend survival with a better quality of remaining life. There are risks during surgery that includes chances of not surviving the operation. Chemotherapy and radiation treatments following surgery can increase life-span by about 10%.

Early detection of pancreatic cancer is difficult which is why the disease is most often not discovered until it has reached advanced stages. Being aware of the symptoms and life style factors that increase the risks are crucial. The earlier it is diagnosed, the better the chance of survival.

Whipple Surgery Video Explanation


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Seena Magowitz Pancreatic Cancer Foundation does not intend to provide specific medical advice. It only provides general information to help users better understand their health. SMF urges all users to always consult with qualified physicians for any diagnosis or answers to specific questions.


This page was last modified on 13 February 2012 at 16:51
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