The Whipple procedure is considered to be one of the most involved and complex surgeries in the field of gastrointestinal surgery.
The Whipple procedure, also medically referred to as a pancreatoduodenectomy, is a complex surgical procedure performed to treat pancreatic cancer, tumors or other conditions affecting the pancreas, extrahepatic bile duct and duodenum. The unique name of this intricate technique is after the surgeon who refined the procedure, Allen Oldfather Whipple.
The procedure involves the removal of the head of the pancreas, part of the duodenum, part of the gallbladder and bile duct, and surrounding lymph nodes. It may also involve the removal of a portion of the stomach, portal vein, or certain arteries when determined necessary. Once these areas are removed, the remaining portions of the pancreas, stomach, and small intestines are reattached to support normal digestion. Our surgeons prefer to perform a “mini-Whipple” procedure, which limits the amount of organs being removed to as few as possible.
When is Whipple procedure recommended?
The Whipple procedure is most commonly performed to treat pancreatic cancer. The procedure the only current method for curing pancreas cancer, as it allows for the complete removal of the tumor and surrounding tissue. This procedure may also be used to treat patients diagnosed with other types of cancer or conditions that affect the pancreas, bile duct, or small intestine, including:
- Pancreatic cancer – a type of cancer that originates in the cells of the pancreas
- Ampullary cancer – a type of cancer that forms from the ampulla of Vater, an area where the pancreatic duct and bile duct empty into the duodenum.
- Bile duct cancer – a rare cancer found in the bile duct that carries bile (digestive fluid) from the liver.
- Neuroendocrine tumors – A type of cancer that can form from hormone-producing cells in the pancreas.
- Duodenal cancer – a type of cancer that starts in the duodenum (the first part of the small intestine), associated with genetic syndromes such as Familial Polyposis Syndrome
- Intraductal Papillary Mucinous Neoplasm of the Pancreas (IPMN): a pre-cancerous mucuous-producing polyp inside of the pancreas duct. The most common type of pancreas cyst
- Bile Duct Polyps: a pre-cancerous growth in the bile duct that can cause jaundice
- Gastrointestinal Stromal Tumor (GIST): an abnormal growth of the lining of the duodenum that can cause ulcers and bleeding
- Serous Cystadenoma of the Pancreas: a non-cancerous growth of the pancreas that can block other organs by growing to large sizes
- Solid Pseudopapillary Neoplasm of the Pancreas: a growth inside of the pancreas that can occur in younger patients and block other organs by growing to large sizes
- Chronic Pancreatitis inflammation of the pancreas that can cause damage and lead to pain and other digestive problems
- Trauma to the pancreas or small intestine: sharp objects that enter the abdomen and severe abdomen injuries from car accidents or other blows to the belly can destroy the pancreas and duodenum requiring emergent reconstruction
How is the Whipple procedure performed?
There are different approaches for how the Whipple procedure is performed, including:
Open surgery – During traditional open surgery, a single incision is made in between your rectus abdominis muscles (“six pack muscles”), providing access to the abdominal cavity.
Laparoscopic surgery – A minimally invasive technique utilizing a camera to gain a better visualization of the surgical area. The procedure is performed using surgical instruments that are inserted through several smaller incisions in the abdomen.
Robotic surgery – A minimally invasive option allowing surgeons to use a robotic device that the surgeon controls to perform more advanced maneuvers during this complex procedure. Minimally invasive options may offer a quicker recovery and less blood loss during the procedure.
Your doctor will evaluate your condition to help determine if an open procedure or a minimally invasive technique would be the most effective option.
What is recovery like after Whipple surgery?
Recovery from a Whipple procedure can take several weeks up to several months. The length of recovery is dependent on each individual case and several factors including the type of procedure performed, the patient’s overall health and their medical history. Some patients may be able to return to their normal activities after two weeks, while others may take several months to return to normal.
- Hospitalization for at least 3 days to a week or more.
- Close monitoring for any signs of complications.
- Pain management to help alleviate comfort.
- Dietary restrictions. Patients may not be able to eat normally for the first few days.
- Patients are encouraged to walk immediately after surgery.
- Avoid any strenuous activity for 2 weeks.
- Instructions for wound care.
- Follow-up appointments with your doctors to monitor recovery.
- Dietary instructions and restrictions.
It is important to follow the instructions provided by your surgeon and the medical team in order to have the best outcome. Patients may experience some side effects during their recovery such as fatigue, nausea, vomiting and diarrhea. These are signs of changes in the digestive system caused by the surgery and patients may need to make some adjustments to their diet for relief. Full recovery can take up to several months. Patients may need to make some lifestyle adjustments such as avoiding alcohol, some foods and some medications during the recovery period.
What are potential risks of Whipple procedure?
The Whipple procedure is a major procedure and there are a number of potential risks associated with its complexities. Complications vary depending on each individual case, and some patients may experience little to no complications at all.
- Infection: At the surgical site or in the abdomen.
- Hemorrhage: Severe bleeding at the surgical site.
- Leakage: Leaking from where the pancreas, stomach, and small intestine were reattached.
- Blood clots: Blood clots can form in the legs or lungs.
- Pancreatic fistula: A fistula can present between the pancreas and another organ.
- Nutritional deficiencies: Surgery can affect the body’s ability to absorb nutrients from food, leading to deficiencies.
- Bowel obstruction: Can occur due to scar tissue, adhesions, or other factors.
- Long-term complications such as diabetes or exocrine insufficiency.
Why Choose NGPG General Surgery?
Our multi-disciplinary team of specialists are internationally-recognized experts in liver, pancreas and bile duct diseases, leading advances in their fields. Our center is a destination for patients across the United States seeking the best care available for their difficult diseases. Our surgeons are also some of the few in the world experienced in robotic Whipple procedures. We offer the experience you need along with the latest advancements in technology to ensure the best possible outcome. Connected with the award-winning Northeast Georgia Health System, we perform surgeries in state-of-the-art surgical settings with access to leading technologies to improve outcomes and reduce discomfort.
Request an Appointment
To request an appointment with NGPG Hepato-Pancreato-Biliary Surgery, please call us at 770-219-9200 or use the form on this page.