If you’ve been diagnosed with pancreatic cancer, you may qualify for the Whipple operation.
The Whipple procedure is the surgical removal of tumors in the head of the pancreas that haven’t spread. It can also treat other types of cancers around the head of the pancreas, such as bile duct and duodenal cancer.
Not every patient will qualify for the Whipple. However, this complex surgery provides the only chance of a cure for pancreatic cancer patients.
Learn more about the Whipple procedure, including the criteria for surgery and what the operation entails.
What Is the Whipple Procedure?
Also known as radical pancreatoduodenectomy, the Whipple operation is the surgical procedure used to treat cancers of the pancreas, the drainage tubes of the liver or bile ducts, and duodenal cancers. This operation can also help with the surgical management of a variety of benign pancreatic conditions.
In the Whipple procedure, the surgeon removes the head of the pancreas and portions of the gastrointestinal (GI) tract. The surgeon then reconstructs the leftover portion of the pancreas and GI tract.
The Whipple procedure is the only cure for pancreatic cancer. It also gives people the best chance for long-term healing.
Which Conditions Does the Whipple Procedure Treat?
The Whipple procedure primarily treats tumors in the head of the pancreas that haven’t spread. It can also treat other cancers and pancreatic conditions, including:
- Ampullary cancer.
- Bile duct cancer.
- Duodenal cancer.
- Neuroendocrine tumors.
- Pancreatitis.
- Pancreatic cysts.
- Pancreatic trauma.
Who Is Eligible for the Whipple Procedure?
Only about 20% of pancreatic cancer patients are eligible for the Whipple procedure. Eligibility requires that your tumor is in the head of the pancreas and hasn’t spread to other organs.
Because of the complexity of the surgery and recovery, your overall health is also a consideration.
If you have pancreatic cancer, talk to your care team about whether you’re a candidate for the Whipple procedure. They may recommend that you have chemotherapy or radiation before the procedure.
If you’re a candidate for the Whipple, having it performed at a high-volume surgical oncology center is best. The Pancreatic Cancer Action Network “strongly recommends” going to a high-volume pancreatic surgeon for the Whipple procedure. A high-volume pancreatic surgeon is a surgeon who performs more than 15 Whipple surgeries a year.
What Happens During the Whipple Procedure?
The Whipple procedure is either an open procedure (requiring a large incision) or a minimally invasive robotic procedure. The minimally invasive robotic Whipple uses keyhole incisions and has a faster recovery and lower risk of postoperative complications.
During the operation, you’ll go under general anesthesia. Your surgeon will make a midline incision (for open surgery) or smaller incisions (for minimally invasive or robotic surgery) in your abdomen.
During the Whipple, the surgeon will remove:
- The head of the pancreas — The head is the wide portion of the pancreas, located on the right side of your body.
- Other parts of the gastrointestinal (GI) tract — Because of the pancreas’s location, the surgeon also removes:
- The duodenum (a portion of your small intestine).
- The gallbladder.
- A portion of the bile duct.
- A portion of the stomach and nearby lymph nodes.
After removing the head of the pancreas and other parts of the GI tract, the surgeon rebuilds the remaining parts of the digestive system. They connect the remaining portions of the bile duct and stomach to the small intestine.
They also connect the remaining portion of the pancreas to the small intestine. This ensures that digestion can occur normally after the procedure. There are no colostomies or bags following a Whipple.
The entire Whipple procedure can take several hours to complete. Afterward, you may spend several days in the hospital to recover and several weeks at home.
Recovering After the Whipple Procedure
The Whipple procedure is a complex surgery, and recovery can take several months. You may have to restrict yourself from activities like driving for at least a month. You also may need to take medication for a while to manage the pain.
Because of the changes to your digestive system, your doctor may recommend that you make dietary changes to avoid complications. You may have to eat smaller portions or avoid certain foods. Your doctor may also recommend you take pancreatic enzymes to help with digestion.
If you have cancer, you may need further treatment like chemotherapy or radiation after the Whipple procedure. These treatments can help kill any remaining cancer cells.
What Are the Benefits of the Whipple Procedure?
The Whipple procedure is the only known cure for pancreatic cancer. The five-year survival rate is between 20% and 25%, significantly higher than the average survival rate of pancreatic cancer. Having a high-volume pancreatic surgeon perform the procedure can increase your odds.
The Whipple procedure can also help improve the symptoms of pancreatic cancer and other conditions.
What Are the Risks and Complications of the Whipple Procedure?
Like any surgery, the Whipple procedure comes with inherent risks, such as bleeding and infection. The surgery also can come with short- and long-term complications, including:
- Bloating.
- Blood clots.
- Diabetes.
- Diarrhea.
- Digestive problems.
- Infections.
- Leakage from the pancreas and bile duct connection sites.
- Nausea and/or vomiting.
- Pain.
- Slow stomach emptying after eating.
- Stomach ulcers.
- Weight loss.
However, most patients don’t experience long-term complications following the Whipple procedure. Talk to your doctor if you experience these symptoms.
Why Go to UPMC for the Whipple Procedure?
Research shows that choosing a high-volume surgical center for the Whipple procedure can lead to fewer complications and better outcomes. UPMC Hillman Cancer Center is one of the most experienced pancreatic cancer surgical centers in the world.
UPMC Hillman is the only Comprehensive Cancer Center in western Pennsylvania, as designated by the National Cancer Institute (NCI).
At UPMC, our surgeons specialize in treating specific cancers. Our pancreatic cancer surgeons helped pioneer the robotic Whipple and perform more robotic pancreatic surgeries than any center in the United States. We have performed more than 1,500 robotic pancreatic surgeries in the past 15 years, including nearly 1,000 robotic Whipples.
In addition to experienced surgeons, we have a multidisciplinary team who focus on all aspects of our patients’ health. The team includes specialists in surgical oncology, medical oncology, radiation oncology, nutrition, mental health care, and more.
We offer novel chemotherapy treatments and/or radiation if you need treatment beyond surgery. We also provide access to more than 400 clinical trials.
With more than 70 UPMC Hillman locations, you can find expert cancer care close to home. For more information about pancreatic cancer care at UPMC Hillman, visit our website.