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Whipple Procedure for Pancreatic Cancer: Things to Know

If you or a loved one has been diagnosed with pancreatic cancer, your doctor might recommend a type of surgery called a Whipple procedure. Also called a pancreatoduodenectomy, this is a highly complex operation that requires a high level of expertise.

Whipple procedures are one of the most common ways to treat pancreatic cancer if it occurs in the head of the pancreas. “Surgery represents the mainstay of treatment for pancreatic cancer,” said Sanjay S. Reddy, MD, FACS, a surgical oncologist at Fox Chase Cancer Center. “Removing the tumor gives the best chance for successful long-term control of this disease.”

Here’s a look at what a Whipple procedure entails, why it can be risky, and why finding the right surgeon is so important.

How it’s done

Whipple procedures are often used to treat tumors in the head or neck of the pancreas that have not spread to other areas of the body. In some cases, patients will undergo chemotherapy or radiation beforehand to shrink the tumor before it’s removed.

The surgery involves making an incision down the middle of the belly. First, the surgeon removes the gallbladder, parts of the small intestine, the bile duct, a portion of the stomach, and also the pancreatic head. The remaining organs are then reattached so food can still be digested. 

Whipple procedures are complicated because they involve so many different organs, but that’s not the only reason.

“The pancreas is located in a very difficult spot, deep in the central part of the abdomen,” Reddy explained. “Even though the tumor may be very small, a lot of different organs are encountered in order to access that area.”

Weighing the risks

Pancreatic cancer is difficult to treat, and the Whipple procedure is the most common surgical option. However, that does not mean that it is without risk or that it isn’t a challenging operation where success can heavily rely upon the experience of the surgeon performing it. Whipple procedures can be lifesaving, but one must also recognize the risks associated with the operation—these can include pancreatic leaks, infections, and bleeding. Patients might also experience slower digestion or other digestive problems, weight loss, changes in bowel habits, and a higher risk for diabetes.    

For those facing pancreatic cancer and considering a Whipple procedure, getting a second opinion, preferably from a surgeon at a high-volume cancer center, is a good idea.

Improving the chance of success

There’s no way to completely eliminate the risks associated with Whipple procedures—they’re highly intricate operations. However, opting to have yours performed by an experienced surgeon at a major cancer hospital can greatly reduce the chances for complications. Reddy says, “Complex surgeries, like the Whipple, that are done on a more routine basis with a more experienced team certainly lend themselves to better outcomes.”

Getting treated at a major cancer center also gives you access to new clinical trials and multidisciplinary care, which can help you achieve the best possible outcome.

“You’ll see a team of oncologists—medicine, radiation, and surgery—that together will tailor treatment plans to the individual,” Reddy noted. “And, you’ll be a part of the decision-making too. You’ll feel like you’re a part of the team.”

Learn more about pancreatic cancer treatment at Fox Chase Cancer Center.