Candidate For The Whipple Procedure-Oncologist Explains

Pancreatic cancer has one of the poorest prognoses among common cancers. Because pancreatic cancer generally develops and spreads before the symptoms appear, only around 6% of patients survive five years following the diagnosis, says a cancer surgeon in Kolkata.

However, a complex surgery known as the Whipple procedure may extend the life and even constitute a cure for certain pancreatic patients. Those who successfully undergo the Whipple procedure may have a five-year survival rate of up to 25%.

The classic Whipple treatment is named after Allen Whipple, MD, a Columbia University surgeon who performed the first American Whipple procedure in 1935.

The Whipple procedure, also known as pancreaticoduodenectomy, includes the extraction of the "head" of the pancreas close to the first part of the small intestine (duodenum). The duodenum, a section of the common bile duct, the gallbladder and sometimes a bit of the stomach are also extracted during this procedure. Following that, doctors will rejoin the remaining intestine, bile duct and pancreas, says the cancer doctor in Kolkata.

Who Is a Whipple Procedure Candidate?

The Whipple surgery and subsequent surgeries are only available to roughly 20% of pancreatic cancer patients. These are typically people whose pancreatic tumours are restricted to the head of the pancreas and have not migrated to any neighboring major blood arteries, the liver, lungs, or abdominal cavity. Intensive testing is usually required to identify potential Whipple surgery candidates, says the surgical oncologist in Kolkata.

Some patients can be candidates for a minimally invasive (laparoscopic) Whipple procedure, which involves numerous small incisions rather than a single major incision. Compared to the conventional technique, the laparoscopic operation may result in less blood loss, a shorter hospital stay, faster recovery and fewer complications. 

The Whipple procedure is not an option for the 40% of newly diagnosed patients whose cancers have expanded (metastasized) outside the pancreas. Rarely, about 40% of patients with a locally advanced illness migrated to nearby areas such as the superior mesenteric vein and artery, or those whose tumours have spread to the body or tail of the pancreas, have this choice, says the cancer surgeon in Kolkata.