The goal of the Whipple procedure is to remove the tumor in the head of the pancreas. Although it is a common surgery for pancreatic cancer, it is a complicated procedure which requires a highly skilled surgeon and a medical complex with good succes rates.
Candidacy for the Whipple Procedure
A resectable tumor contained entirely within the pancreas and localized within the head of the pancreas is a perfect candidate for a Whipple Procedure.
The head of the pancreas is surrounded by important blood vessels – the superior mesenteric vein and artery, which supply blood to the intestine and liver. The pancreatic cancer should not invade these blood vessels to qualify for surgery. This is determined via high quality imaging like CT scan with endoscopic sonography.
The Whipple Procedure for Pancreatic Cancer
The operation involves the removal of the head of the pancreas, which contains the tumor. Usually about 20% of the pancreas is resected.
The bottom part of the bile duct, the first portion of the duodenum, gall bladder, surrounding lymph nodes and occasionally a portion of the stomach are removed to ensure the removal of organs possible invaded by cancer cells.
The remaining portions of the pancreas, bile duct, duodenum and stomach are stitched together to preserve the continuity of the digestive tract. After ample time to recover and heal, the pancreas will produce digestive juices and enzymes, which will pass through the bile duct towards the duodenum to aid in food digestion and absorption.
What Happens After the Whipple Procedure
Chemotherapy and radiation therapy are usually considered after a Whipple procedure for pancreatic cancer. Even with the high accuracy of detailed imaging studies pre-operatively and the expertise of the oncologist, some cancer cells may evade detection. Supplement therapies will ensure that no cancer cells are missed.
A study has shown that at least an additional 10% benefit for long-term survival is achieved with adjuvant chemotherapy and radiation therapy.
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Awareness of the Whipple procedure for patients with pancreatic cancer leads to understanding the available treatment options and eventually enables a patient to make an informed decision. Questions and second thoughts should be clarified so that the patient and their families and loved ones feel enlightened about the path they will be taking. No one should go through pancreatic cancer alone, and definitely, no one should go through a Whipple procedure without proper information and understanding.
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