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Diagnosis of the Whipple Procedures

The Whipple procedure is the common term for a form of surgery used to treat chronic pancreatitis, pancreatic cancer and a number of other cancers. Its formal name is a pancreaticoduodenectomy. In addition to removal of part of the pancreas, the surgery involves removal of the gall bladder and the first section of the small intestine, the duodenum. Doctors determine the suitability of the Whipple procedure on a case by case basis.

  1. Determining Suitability for Treatment

    • The Whipple procedure is most typically associated with the treatment of pancreatic cancer. If you are initially diagnosed with pancreatic cancer, your oncologist will likely schedule you for surgery as soon as possible. Although you will be tentatively scheduled to undergo a full Whipple procedure, your surgeon will not know if you are a good candidate for the procedure until surgery has begun. According to the Patient Education Center at Harvard Medical School, roughly 40 percent of all pancreatic cancers have metastasized to other parts of the body before a diagnosis is made, making further surgery ineffective. An additional 40 percent of cases involve cancers that have not substantially spread, but are too entwined with major blood vessels near the pancreas to allow safe surgical removal. The remaining 20 percent of cases are potentially suitable for the Whipple procedure.

      If you are in this 20 percent, your surgeon will need to examine your pancreas further to see where the cancer is located within the organ. In most instances, tumors are located in one end of the pancreas, known as the head or in an adjacent section known as the uncinate process. If your tumor is in one of these two areas, your surgeon will proceed with the Whipple procedure. However, if your tumor is located in the main portion of the pancreas, or in its tail end, he may judge the cancer to be too far advanced for surgical treatment. If this is the case, your surgeon will discontinue your Whipple procedure and your cancer will be addressed through other treatment options.

    Performing the Procedure

    • If you are scheduled for the Whipple procedure, you should be prepared for a very extensive surgery. While the head of the pancreas itself is small, it is structurally tied into a number of nearby ducts and organs, including the duodenum, gall bladder and the common bile duct. In order to remove your cancer, your surgeon must also remove these related sections. Typically, the procedure begins with detachment of your duodenum from the stomach. The head of your pancreas, which is attached to the duodenum, is then removed, and the lower section of the duodenum is detached from the rest of the intestine. Finally, the common bile duct is detached, along with the gall bladder. Your surgeon will then reconnect your remaining pancreas and small intestine.

    Recovery and Potential Complications

    • Recovery from the Whipple procedure requires a hospital stay of roughly 2 to 3 weeks. Potential complications include leakage of pancreatic and bile, as well as infection. Consult your surgeon for a full explanation of what to expect.

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