Whipple Surgery Explained: Purpose, Risks, and Treatment Process

Pancreatic cancer, chronic (long-term) pancreatitis, Cholangiocarcinoma (a cancer of the bile duct), and other related medical conditions require a most common type of surgery called Whipple procedure (or Pancreaticoduodenectomy). To remove several gastrointestinal tract organs that are frequently implicated in the spread of pancreatic cancer, including the small intestine, gallbladder, and occasionally the stomach, multiple surgeries are performed during a single operation.

Whipple surgery recovery is usually difficult. Recuperating from such an operation, regaining the capacity to digest food, gaining the weight that is typically lost, and getting over the weariness and stress that follow this kind of surgery usually takes two months or longer. Whipple surgery cost can be overwhelming, but it is worth the amount a person invests in it.

What is the Purpose of Whipple Surgery?

The primary purpose of the Whipple procedure, also known as a pancreaticoduodenectomy, is to remove cancerous tumours located in the pancreas’s head or neck. This complex surgery involves removing the pancreas’s head, the gallbladder, a part of the bile duct, the duodenum (the initial part of the small intestine), and sometimes a portion of the stomach.

The Whipple procedure is the most common surgery for pancreatic cancer and offers the best chance for long-term control of the disease. It is estimated that only 15-20% of pancreatic cancer patients are eligible for this surgery, as the cancer must be localised to the head of the pancreas and not have spread to other organs. Even with the surgery, the 5-year survival rate for pancreatic cancer is only around 25%.

In addition to pancreatic cancer, the Whipple procedure may also be performed for other conditions affecting the pancreas, duodenum, or bile duct. The surgery aims at removing the entire tumour and surrounding lymph nodes to prevent cancer from spreading further.

What is the Treatment Process of Whipple Surgery?

The treatment process of Whipple surgery includes – before, during, and after the surgery. It is important to get ready for the surgery in advance. Here are the Whipple surgery steps involved – 

What Happens Before Whipple Surgery?

One can do a lot of things to get ready for Whipple surgery. Among them are – 

• Speaking with the surgeon about the drugs the patient takes and receiving advice on which ones (like blood thinners) to cease taking before surgery
• Maintaining a nutritious diet (be ready to lose weight after the surgery)
• Keeping up a healthy lifestyle (such as going to the gym regularly)
• Giving up smoking
• Giving up alcohol consumption

Observe the protocols set forth by the medical professional (a preoperative examination should be arranged, along with detailed instructions on how to get ready for surgery).

What Happens During the Procedure?

During the Whipple surgery procedure, the surgeon removes the head of the pancreas, a specific portion of the bile duct, the gallbladder, a section of the duodenum (the first part of the small intestine), and sometimes a part of the stomach. This intricate surgery typically lasts between 4 and 12 hours and is performed under general anaesthesia to ensure the patient is unconscious and doesn’t feel any pain throughout the procedure.

The Whipple surgery procedure is a significant surgery with a high risk of complications, requiring a skilled and experienced surgical team to manage any potential issues effectively. While minimally invasive laparoscopic surgery is joint for many procedures, the Whipple surgery is usually performed as an open surgery due to its complexity. 

Recovery from Whipple Surgery

Recovery from the Whipple procedure is gradual, with patients typically staying in the hospital for about a week and needing 4-6 weeks to resume normal activities if there are no complications. In rare circumstances, healing may take up to six months. The patient won’t be allowed to eat or drink anything after surgery, and it will usually take a long time for them to recover their average ability to digest food. The gastrointestinal system will also take time to heal. The surgical team will advise them on what and when to eat.

The most crucial thing to remember in the healing process is that each person is unique. Here’s what life after the Whipple procedure looks like – 

• The patient won’t be allowed to eat or drink for several days following surgery.
• It is recommended that the patient go for a little stroll on the first day after the surgery and then gradually extend the walk every day after that.
• After the Whipple treatment, they probably won’t have a bowel movement for a few days.
• The surgical incision site will have multiple drainage tubes to collect fluid. These will likely be left in place when the patient is discharged, and the discharge nurse will provide them with information on how to take care of the wounds at home.
• The first step in pain management is using a pain pump, which is intended to enable self-administration of pain medicine.
• The patient will be given oral (taken by mouth) pain medicine once they start eating solid meals.
• An oral pain medication prescription will be given to them upon release.

Risks and Complications of Whipple Surgery

The Whipple procedure is a complex surgery primarily used for pancreatic cancer. Though it is pretty effective, it carries various risks and potential complications. Some of the common Whipple surgery complications include –

• Post-operative leaking of pancreatic juices, which may require the insertion of a drain for several weeks
• Bleeding from the gastroduodenal artery necessitates medical intervention to stop it. 
• Additionally, some patients may develop diabetes post-surgery, experience mouth sores or oral thrush, and face risks of pain and infection typical of any surgical procedure.

Less common but severe Whipple surgery complications include – 

• Infections
• Delayed gastric emptying
• Pancreatic leaks
• Bile leaks at the surgical site. 

The surgical team’s and hospital’s expertise significantly impact recovery and survival rates, with patients treated at specialised centres like Omni Hospitals offering higher chances of long-term survival with effective recovery. Despite the risks, the Whipple procedure is a treatment option for eligible patients, offering improved survival rates for pancreatic cancer patients.

Conclusion

The Whipple procedure is a crucial surgical intervention for pancreatic cancer that helps in controlling and managing the condition for a long time. The surgery involves the removal of the head of the pancreas, a portion of the bile duct, the gallbladder, and sometimes parts of the duodenum and stomach. Though there are certain risks and complications associated with the surgery, which include postoperative leaking of pancreatic juices and infections, it remains a curative treatment for resectable and borderline resectable pancreatic ductal adenocarcinomas.

It is important to have Whipple surgery at Omni Hospitals, which is renowned for its years of medical expertise and board-certified surgeons.

FAQs

Q1. What is the survival rate for a Whipple procedure?

Ans. The survival rate of the Whipple procedures has increased over the past few decades with the advancement of technology and medical interventions. Today, the mortality rate is about 1%-3%.

Q2. What should be my diet after the Whipple procedure?

Ans. Patients are advised to be on a clear and liquid diet for a certain period. The surgeon will suggest when they must resume solid foods. 

Q3. What are the advantages of the Whipple procedure?

Ans. A Whipple procedure increases the survival chances of pancreatic cancer. It usually takes 2-6 months to get fully back to normal.