In the Whipple operation, the head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum is removed. Occasionally, a portion of the stomach may also be removed. After removal of these structures, the remaining pancreas, bile duct and the stomach is then connected to the intestine to restore gastrointestinal function.
For certain patients, a minimally invasive laparoscopic Whipple operation may be performed. This innovative approach utilizes a laparoscopic hand-access device. Currently, this procedure may be offered to select patients with small pancreatic adenocarcinoma, chronic pancreatitis, cystic tumors and islet cell tumors of the pancreas, as well as patients who have ampullary cancer.
Recent studies have shown that of a Whipple operation is dependent upon the experience of the hospital and the surgeon performing the surgical procedure. In those medical centers, such as Hoag Digestive Health Institute, which perform a high volume of these procedures, the mortality rate from the Whipple operation is less than four percent. However, in medical centers that infrequently perform the Whipple operation, a much higher complication rate and mortality rate (often greater than 15-20%) have been reported.
The Hoag surgical team performs over 1000 Whipples per year program-wide, the highest volume in Orange County. Being a high-volume surgical center enables the Hoag surgical team to achieve a technical skill level not all facilities can match.
It has been shown that surgery for pancreatic cancer offers a much better survival rate than chemotherapy alone.
The Whipple operation is a complex operation with a high chance of developing complications. Just as the survival rate is better when seeking treatment at a high volume, highly-experienced center, complication rates for pancreatic cancer surgery are much lower when seeking care at a high volume center.
In addition to surgical risks, it’s important to be aware that there are some long-term consequences that some patients experience as a result of the Whipple operation, including:
Increased Risk of Diabetes: During the Whipple operation part of the pancreas is removed. Pancreatic tissue produces insulin that is required for blood sugar control. When pancreatic tissue is removed the body releases less insulin, and therefore, the risk of developing diabetes may increase. However, for most patients with normal blood sugar prior to surgery, and no history of diabetes or chronic pancreatitis, there is a low probability of developing diabetes as a result of the Whipple operation.
Mal-absorption: The pancreas produces enzymes required for digestion of food. In some patients, removal of part of the pancreas during the Whipple operation can lead to a diminished production of these enzymes that may change absorption of important nutrients and also affect bowel movements. Long-term treatment with oral pancreatic enzyme supplementation usually provides relief with this issue.
Loss of weight: It is common for patients to lose up to 5-10% of their body weight compared to their weight prior to illness. Weight loss usually stabilizes very rapidly after surgery, and most patients are able to maintain their weight and do well.
In general, a Whipple operation may be recommended for treatment of:
Cancer of the Duodenum (first part of the small intestine immediately beyond the stomach)
Cancer of the Ampulla (an area where the bile and pancreatic duct enter into the duodenum)
Certain Benign Disorders such as Chronic Pancreatitis and benign tumors of the head of the pancreas
It’s important to note that the Whipple Operation is not appropriate for every patient. At Hoag, our multidisciplinary team of experts includes pancreatic surgeons, medical oncologists, hepatologists and radiologists who work together to thoroughly review and determine the best treatment option suited to each individual patient.
Studies have shown that proper diagnosis, staging and successful surgical outcomes are highly dependent upon the experience of the treatment team in accurately diagnosing and treating pancreatic disease. Outcome research studies have also suggested that best outcomes from the Whipple operation are directly related to the experience of the surgeon in performing this highly complex operation, which is why choosing the right surgeon is vital.
While some surgeons perform Whipple procedures on a small number of patients, Hoag performs more Whipple Operations than any other medical center in Orange County. Being a high-volume surgical center enables the Hoag surgical team to achieve a technical skill level not all facilities can match.
With its exceptional team of physician experts and staff, progressive technology, and state-of-the-art surgical facilities, it’s easy to see why Hoag continues to lead the way in comprehensive hepatobiliary and pancreatic disease treatment.
The hepatobiliary and pancreatic disease experts at Hoag Digestive Health Institute continue to lead the way in progressive patient-centered gastrointestinal treatment.
To determine if you are a candidate for the Whipple Operation, speak with your physician, or contact us to schedule an appointment at 949-764-8379.