Thursday, April 18, 2024

Whipple Surgery For Pancreatic Cancer

After Whipple Surgery: How To Recover

WVU Medicine Health Report: Robotic Whipple for Pancreatic Cancer

After surgery, you’ll likely stay on a surgical floor. If you have other health conditions or a complicated surgery, you might stay in the ICU.

Your nurses and doctor will watch you closely for post-op problems or infections.

You won’t eat anything by mouth for a few days while your digestive system heals. But you will be up and walking short distances on the first day after surgery.

You’ll likely have a pain pump to manage any pain.

Your doctors will also run tests to see if all the cancer is gone and make sure your lymph nodes are cancer-free.

After one to two weeks healing in the hospital, you’ll head home.

Home recovery can be lengthy, so you’ll need someone to help care for you.

For the first four to six weeks, you may not drive or return to your daily routine.

Most people take six to nine months to heal fully. Others will need a year before they’re back to feeling normal.

Some people also need adjuvant therapy after surgery. This may include chemo, radiation, or both. It will help destroy any small cancer cells left after surgery.

After Whipple surgery, you may need to:

  • Adjust your diet to help reduce stomach problems like gas, pain, or diarrhea.
  • Eat small meals.
  • Avoid greasy or fatty foods.

What Happens Before The Whipple Procedure

If you have cancer, you may go through radiation or chemotherapy before you have the surgery.

Your surgeon will instruct you to stop taking certain medications in the days leading up to your surgery. You should also:

  • Avoid food and drinks for eight hours before going to the hospital for your Whipple procedure, unless directed otherwise.
  • Quit smoking even if its just for two weeks before the Whipple procedure to improve heart and lung health.
  • Stop taking herbal supplements for one to two weeks before the surgery as directed by your healthcare provider.
  • Not take Viagra® or other medications for erectile dysfunction at least 24 hours before a Whipple procedure.
  • You should take certain blood pressure medications with a sip of water as instructed by your provider.

Once at the hospital, your nurse will insert an intravenous line into your arm to inject fluids and medications youll need during the surgery. Additionally, an epidural catheter or spinal injection may be necessary. They block your nerves, helping decrease pain after surgery.

Questions To Ask The Surgeon

  • Can my tumor be removed through surgery? Why or why not?
  • How many pancreatic surgeries have you performed? How many in the past year?
  • How many pancreatic surgeries are performed at your hospital every year?
  • What are the possible complications of pancreatic surgery?
  • How long should I expect to be in the hospital recovering after pancreatic surgery?
  • Would you be able to recommend another experienced surgeon for a second opinion?

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Whipple Procedure Outcomes And Survival Rates

The Whipple is a complex procedure. The expertise of your care team and hospital is a key factor in your recovery and survival. Patients who underwent the procedure at specialty centers who have performed a higher volume of pancreaticoduodenectomies had a higher chance of five-year survival, according to ongoing research. Survival is also impacted by other factors, such as how far the cancer has spread beyond the pancreas at the time of diagnosis and surgery.

The overall five-year survival estimate for people with all stages of pancreatic cancer is 10 percent, according to CA: A Cancer Journal for Clinicians. The survival rate for each stage includes:

  • Localized disease: 39 percent
  • Distant: 3 percent

What Is Pancreatic Cancer

Department of Surgery

This type of cancer is caused by a growth in your pancreas. The tumor usually grows in the head, neck or body of your pancreas. Few grow in the tail. Pancreatic cancer is primarily caused by smoking and most of those diagnosed are between the ages of 60 and 80 years.

Yearly in the U.S., about 57,000 people are diagnosed with pancreatic cancer and there are around 46,000 deaths. Only roughly 8.5% of people with this type of cancer live for another five years after their diagnosis.

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Treatment For Pancreatic Cancer

Our surgeons offer extensive expertise in the most advanced minimally invasive procedures for cancer of the pancreas, using laparoscopic techniques when appropriate. Types of surgery include:

  • Pancreatoduodenectomy involves removal of the head of the pancreas, part of the small intestine, the gallbladder and part of the common bile duct, part of the stomach, and lymph nodes near the head of the pancreas. Most pancreatic tumors occur in the head of the pancreas, so the Whipple procedure is the most commonly performed surgical procedure for pancreatic cancer.
  • Pylorus-preserving pancreaticoduodenectomy is similar to the Whipple procedure. However, your surgeon does not remove the lower part of your stomach.
  • Robotic distal pancreatectomy removes benign and malignant cysts and tumors in the body or the tail of the pancreas using the da Vinci® Surgical System
  • Total pancreatectomy includes removing the entire pancreas, part of the small intestine and stomach, the common bile duct, the spleen, the gallbladder and some lymph nodes. This type of operation is not done often.
  • Palliative surgery involves more advanced cancers. Surgery may be done not to cure the cancer, but to relieve problems such as a blocked bile duct.
  • Portal vein resection for selected patients.
  • Newer surgical procedures are used to remove larger tumors that were previously considered inoperable.

Learn the questions to ask about pancreas cancer treatment.

Enhancing Healthcare Team Outcomes

The involvement of an interprofessional team in the management of cancer patients is of the essence, and pancreatic cancer is no exception. The success of pancreaticoduodenectomy depends on a meticulous selection of surgical patients for resectability using a CT of the abdomen with the pancreas protocol. The nurses, physiotherapists, counselors, oncologists play a crucial role in delivering optimum care to the cancer patient.

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Am I Too Old For The Whipple Procedure

While there is no age limit for the Whipple procedure, age-related issues and conditions may impact a patients medical course and outcome. The geriatric oncology experts in the Specialized Oncology Care & Research in the Elderly clinic assist our oncologic surgeons in evaluating older patients considering the procedure.

Diagnosis Of Pancreatic Cancer

Whipple Procedure for Pancreatic Cancer: Alexandra Salvador’s Story

If you are having symptoms of pancreatic cancer, your surgeon will ask about your health history, your familys history of cancer and risk factors. Diagnostic tests may include:

  • Endoscopic ultrasound
  • Computed tomography scan
  • Magnetic resonance imaging
  • Pancreas biopsy. A procedure in which a sample of pancreatic tissue is removed for examination under a microscope.
  • Special blood tests

Learn more about the above diagnostic tests for pancreatic cancer.

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How Is The Whipple Procedure Performed

At UChicago Medicine, the Whipple procedure is performed using one of the following surgical techniques:

  • The traditional open method requires an incision down the middle of the patients belly. Patients usually recover in the hospital for seven to 10 days.
  • The minimally invasive robot-assisted method involves multiple small incisions. This may result in a shorter hospital stay and reduced pain and scarring.

Whether open or robotic, the Whipple procedure requires a high level of surgical training and excellent technical skills. UChicago Medicine has one of the most experienced teams of surgeons in the country performing the Whipple procedure.

Surgery For Pancreatic Cancer

Two general types of surgery can be used for pancreatic cancer:

  • Potentially curative surgery is used when the results of exams and tests suggest that its possible to remove all the cancer.
  • Palliative surgery may be done if tests show that the cancer is too widespread to be removed completely. This surgery is done to relieve symptoms or to prevent certain complications like a blocked bile duct or intestine, but the goal is not to cure the cancer.

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How Will I Feel After Having The Whipple Procedure

Following the surgery, you may experience pain from the incision. You can resume eating and drinking by mouth several days after surgery. At first, the stomach may not empty well, causing a bloated or full feeling. In some cases, medication is necessary to help your digestive system work properly. You may have a decreased appetite, which may take several weeks to improve.Your care team at UChicago Medicine works to enhance recovery so patients can go home as quickly as possible.

Whipple Procedure And Its Benefits

Whipple procedure: best treatment for pancreas cancer

The Whipple Procedure involves removing the head of the pancreas, the distal bile duct, and a few other segments. Part of the stomach and adjacent veins and/or arteries may be removed for some patients. The procedure is usually done through a single incision in the upper belly, but multiple smaller incisions can also be done. The purpose of a Whipple procedure is to extend a patients life or, in some cases, to cure them of cancer. The goal for certain patients may be to prevent or reduce symptoms such as discomfort or bile duct or stomach blockage.

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Is Whipple Procedure The Cure For Pancreatic Cancer

A pancreaticoduodenectomy is another name for the Whipple procedure. Most cancer patients know what is a Whipple procedure as it is the most common surgical treatment for pancreatic cancer that has spread to the glands head. In this procedure, the pancreatic head, duodenum, and a section of the intestine, gallbladder, and accompanying lymph nodes are the organs that are being removed. This type of operation is used to remove pancreatic cancer and is determined by the tumors location. A Whipple procedure is used to treat malignancies of the head and neck of the pancreas. This procedure is quite complicated.

The Whipple procedure is a complex and demanding procedure that comes with serious risks. However, this method can save a persons life, especially if they have Pancreatic cancer.

Who Is The Best Surgeon For A Whipple

Pancreatic surgery is very complicated. Data show high volume surgeons at high volume hospitals have higher success rates and fewer complications. The Pancreatic Cancer Action Network strongly recommends you have a high volume pancreatic surgeon perform the surgery.

PanCAN Patient Services can provide more information, including a list of institutions and doctors who perform a high volume of pancreatic surgeries.

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What Other Treatment Will I Need

Patients typically receive a total of six months of chemotherapy as part of their treatment. Prior to surgery, chemotherapy is given to shrink the size of the tumor and treat the entire body. If the patient received less than six months of chemotherapy before surgery, the remaining course is given after the patient has recovered from the operation. Patients who have a robot-assisted Whipple procedure may be able to continue their intended course of chemotherapy sooner, due to the shorter recovery time after this approach.

Pancreatic Surgery At Moffitt Cancer Center

UPMC OnTopic Video | Whipple Surgery for Pancreatic Diseases

At Moffitt Cancer Center, our multispecialty team of experts treats many patients with pancreatic tumors. Because a surgeons skill is further refined with each Whipple procedure performed, Moffitt is able to offer a level of surgical expertise that far exceeds that of most other cancer centers .

Moffitt is also nationally recognized for performing landmark research that has led to the discovery of many new drugs, surgical techniques and other treatment options. Our goal is to make our breakthrough discoveries available to patients as quickly as possible. For instance, through our robust clinical trial program, our patients have opportunities to be among the first to benefit from promising new pancreatic cancer therapies.

“Today, the Whipple Procedure is safe for treating tumors around the head of the pancreas when performed by expert surgeons in a hospital that has been performing many Whipple procedures over a long period of time.”

Mokenge Malafa, MD.

If youd like to learn more about the Whipple procedure , the experts at Moffitt can provide one-on-one support to help you fight pancreatic cancer. Call or complete a new patient registration form online. We do not require referrals.

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Risk During Whipple Surgery

The Whipple Operation is a major surgery with degrees of variable risk. The extreme risk is not surviving the surgery. In the 1960s and 70s, about 25% of patients did not survive the operation. Today, with medical advancement and experience, it is a much safer operation with a significant reduction in mortality rates during surgery.

A study from Johns Hopkins and Memorial Sloan Kettering shows a correlation of survival rate versus the experience of both hospital and surgeon. Hospitals that perform a high number of Whipple operations experience a death rate of less than 4%. Those hospitals that perform few Whipple surgeries may experience a significantly higher death rate. A study by The New England Journal of Medicine found operative mortality rates to be four times higher at low-volume hospitals versus high-volume hospitals.

Why Experience Matters

This is a difficult, complex procedure. Whipple surgery requires a great deal of expertise. Having a highly experienced surgeon leads to fewer risks and better results.

At UVA, we have master surgeons with unmatched experience. We perform more than 55 Whipple surgeries a year. This helps us keep our high level of expertise and skill. In fact, we do more than five times the recommended standard of procedures.

Don’t be afraid to ask your surgeon about their knowledge and experience. And get a second opinion to make sure you feel confident in your treatment team.

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What Are The Long

Complete recovery from the Whipple procedure can take up to two months. But in rare cases, it can take up to six months to recover.

Patients usually need to take a daily vitamin with iron and a daily medication to reduce stomach acid. Some patients temporarily have trouble regulating their blood sugar levels. Your doctor will determine if you need long-term medication to control blood sugar. Overweight patients and those with pre-existing diabetes may require insulin after their surgery.

How Well It Works

Whipple procedure: best treatment for pancreas cancer

When all of the cancer is removed during a Whipple surgery, it can help a person live longer. Even when this surgery is successful, the cancer often eventually comes back.

The Whipple procedure is a complex surgery. Some risks of this surgery include:

  • Trouble with the stomach emptying after eating.
  • Leaking at the connections the surgeon makes.
  • Infection or bleeding.

Current as of: September 8, 2021

Medical Review: E. Gregory Thompson MD – Internal Medicine& Kathleen Romito MD – Family Medicine

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use how we develop our content .

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Before Whipple Surgery: How To Prepare

Before surgery, you:

  • Might need treatment to shrink the tumor to increase the odds of the Whipple’s success. This often involves a mix of chemotherapy and radiation.
  • Might need further testing, depending on your age and any other health problems you have.
  • Will likely need to stop eating, drinking, and taking certain drugs the night before surgery.

On the morning of surgery, after you check into the hospital:

  • A nurse will insert an IV to give you medicine and fluids.
  • You may need an epidural catheter or spinal nerve block. These help reduce pain as you recover the first few days after surgery.

Recovery From The Whipple Procedure

Patients undergoing a Whipple procedure will be in the hospital for one to two weeks following surgery to be monitored for any signs of complications. For the first few days following surgery, patients will be restricted from solid food. Specific instructions will be provided to patients for their recovery at home. Patients may feel fatigued for around two months following surgery.

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Will I Need A Feeding Tube After Surgery Will I Be On A Special Diet

Most patients do not need a feeding tube. It is generally best to eat a bland diet for the first several weeks after surgery. Nutritional supplements are sometimes helpful for improving strength and maximizing the healing process. Some patients will require enzyme pills taken with meals to replace what the pancreas normally makes. Patients receive instructions on how to maintain a proper diet before leaving the hospital.

Removing Part Of A Vein

The Whipple Procedure | Johns Hopkins Medicine

Sometimes the cancer grows into or around major blood vessels near the pancreas such as the superior mesenteric and portal veins. To remove the cancer, the surgeon may need to remove part of the vein. The vein is then joined back together. This is called vein resection and reconstruction. It is sometimes done by putting in a piece of vein from somewhere else in the body or using an artificial material this is called a graft.

Vein resection makes the surgery more complicated, and it may take longer. You need to be very fit and well to have this type of surgery.

This type of surgery might not be available at your nearest specialist centre. You may be referred to another specialist centre to have the surgery. You can also ask for a second opinion from another surgeon who is experienced in doing vein resections.

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Whipple Procedure For Pancreatic Cancer: How To Prepare And What To Expect

. View Dr. Lewis disclosures.

The Whipple procedure, also called a pancreaticoduodenectomy, is a complicated operation in the upper abdomen that is named for the surgeon who pioneered the technique, Dr. Allen Whipple. It involves removal of the head of the pancreas, part of the adjacent small intestine called the duodenum, the common bile duct, and the gallbladder. Following their removal, the surgeon reconnects the remaining organs.

The Whipple procedure is almost always recommended for pancreatic cancer, which has 2 main types: adenocarcinoma and neuroendocrine tumors of the pancreas. It is sometimes also performed for cancers in the bile duct passing through the head of the pancreas and ending in the small intestine. Rarely, it is performed for an inflammatory condition called chronic pancreatitis.

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