What is the Whipple procedure?
The Whipple procedure, also known as a pancreaticoduodenectomy, is a complex surgical operation often used to treat cancers located in the pancreas, bile duct, or small intestine. It involves removing the head of the pancreas, the duodenum (part of the small intestine), the gallbladder, and sometimes part of the bile duct and stomach. The remaining parts are then reconnected to allow normal digestion. This procedure is typically performed to treat pancreatic cancer but may also be used to address other conditions affecting these organs, such as benign tumours, chronic pancreatitis, or bile duct cancers.
Who might need a Whipple procedure?
The Whipple procedure is most commonly used to treat pancreatic cancer, especially when the tumour is located in the head of the pancreas. Other conditions that may require this surgery include:
- Ampullary cancer: Cancer that forms in the area where the bile duct and pancreatic duct meet.
- Bile duct cancer (cholangiocarcinoma): Cancer affecting the bile ducts.
- Small intestine cancer: Tumours located in the duodenum.
- Pancreatic cysts: Some large or symptomatic cysts that may have malignant potential.
- Chronic pancreatitis: In certain cases where pain or complications cannot be managed with other treatments.
How is the Whipple procedure performed?
The Whipple procedure is a major and intricate surgery that typically takes several hours to complete. It involves removing part of the pancreas and nearby organs, followed by a reconstruction phase to restore digestive function. The steps involved include:
- Removal of affected organs: The surgeon removes the head of the pancreas, the duodenum, the gallbladder, and part of the bile duct. Sometimes, part of the stomach and lymph nodes around these organs are also removed if necessary.
- Reconstruction: After removing the affected areas, the surgeon reconnects the remaining parts of the pancreas, stomach, and bile duct to the small intestine. This allows digestive enzymes, bile, and food to pass through the digestive tract normally.
The Whipple procedure is usually performed through an open surgery (using a large incision) or, in some cases, using minimally invasive techniques such as laparoscopic or robotic-assisted surgery, depending on the case and surgeon’s expertise.
Risks and complications of Whipple procedure
As with any major surgery, the Whipple procedure comes with risks, including:
- Infection: Post-surgical infections at the site of the incision or within the abdomen are possible.
- Bleeding: Due to the complexity of the surgery, bleeding may occur during or after the procedure.
- Pancreatic fistula: A leakage of pancreatic fluid can develop at the surgical site.
- Delayed gastric emptying: The stomach may have difficulty emptying food after surgery, causing nausea and vomiting.
- Digestive issues: Some patients experience difficulty digesting food, leading to weight loss or diarrhoea.
- Diabetes: If a large portion of the pancreas is removed, insulin production may be affected, leading to diabetes.
While complications are possible, the Whipple procedure is often the best option to remove certain cancers and improve long-term outcomes.
Recovery after Whipple procedure
Recovery from Whipple procedure can take time due to the complexity of the operation. Patients typically remain in the hospital for 1 to 2 weeks post-surgery, and full recovery can take several months. Common aspects of recovery include:
- Hospital care: In the initial post-operative period, patients will be closely monitored in the hospital to ensure that there are no complications. Pain management, fluid intake, and early mobilisation are essential aspects of this phase.
- Dietary changes: Initially, patients may be placed on a liquid diet, gradually reintroducing solid foods as the digestive system adapts to the changes made during surgery.
- Follow-up care: Regular follow-up visits are necessary to monitor recovery, manage any complications, and check for any recurrence of cancer.
Why choose Birmingham Liver Clinic?
At Birmingham Liver Clinic, we provide expert care for patients undergoing the Whipple procedure. Our team of highly skilled HPB (hepato-pancreato-biliary) are experienced in handling complex cases and ensure the highest quality care using the latest technologies and surgical techniques.
Contact us
If you are considering or have been recommended for the Whipple procedure, Birmingham Liver Clinic is here to support you. Our team of HPB surgeons will guide you through every step, from diagnosis to post-surgery recovery. Contact us today to schedule a consultation and discuss your options for treatment.
