(Pancreaticoduodenectomy; Classic Whipple; PP Whipple; Pylorus-preserving Pancreaticoduodenectomy; Pylorus-preserving Whipple Procedure)
A Whipple procedure is complex surgery to remove part of the pancreas along with the:
Reasons for Procedure
You may have this surgery to treat cancer of the pancreas, duodenum, or lower part of the bile duct. It may also be done to treat people with long-term inflammation of the pancreas.
If you are planning to have a Whipple procedure, your doctor will review a list of possible complications. These may include:
Complications that occur during surgery may include:
Smoking may increase the risk of complications.
Discuss these risks with your doctor before surgery.
What to Expect
Prior to Procedure
Before surgery, your doctor may do the following tests:
Your doctor may put you on a special diet before the surgery to help your body prepare. If you are not able to eat, you may need to go to the hospital several days before surgery. You will be given glucose and fluids through an IV.
Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure, like:
General anesthesia will be used. It will block any pain and keep you asleep during surgery.
Description of the Procedure
A large incision will be made in the abdomen. The head of the pancreas and the gallbladder, duodenum, and pylorus will be removed. Nearby lymph nodes may also be removed. The remaining pancreas and digestive organs will be reconnected. This will allow the digestive enzymes from the pancreas and stomach contents to flow into the small intestine. In some cases, the pylorus is not removed. The doctor will close the incision with stitches or staples.
You may have many small tubes placed after the procedure. Some will help drain fluid from the surgery site. Another tube may go into your stomach to help prevent nausea and vomiting. A tube may go to your intestines so you can receive nutrition.
Immediately After Procedure
After surgery, you will stay in the intensive care unit for several days. This will help the doctors and nurses monitor your progress.
How Long Will It Take?
How Much Will It Hurt?
Pain or soreness during recovery will be managed with pain medicine.
Average Hospital Stay
You will need to stay in the hospital until your intestines begin to work again. This usually takes two weeks. You may need to stay longer if there are any problems.
At the Hospital
During surgery, your doctor may have placed a jejunostomy tube (j-tube). You will receive nutrients through this tube until your intestines are working normally. After the tube is removed, you can gradually progress to a soft diet, then to regular food.
Other tubes will be removed as you recover.
This surgery will affect the way your body digests food. You may feel bloated or full after eating. You may have nausea and vomiting. Talk to your doctor or dietician to learn how you should eat. You may need to start new medicines to help with digestion and medicines to help control your blood sugar.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
Be sure to follow your doctor’s instructions.
Call Your Doctor
After you leave the hospital, contact your doctor if any of the following occurs:
In case of an emergency, call for medical help right away.
National Cancer Institute
Pancreatic Cancer Action Network
Canadian Cancer Society
Pancreatic Cancer Canada
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6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed March 2013 by Marcin Chwistek, MD