Pancreatic Cancer

Whipple Surgery for Pancreatic Cancer: A Comprehensive Guide

The pancreas is an endocrine gland present in the upper abdomen of your body. It has two main functions i.e., it produces enzymes that digest food. Secondly, it produces insulin that regulates blood sugar levels in your body. 

But when you are diagnosed with pancreatic cancer, then all these functions are disrupted. Cancer can block the bile duct, which causes digestive issues. 

If you are in the early stages of pancreatic cancer, then the doctor recommends Whipple surgery. It is a surgical procedure to remove the cancerous tumour from the head of your pancreas. Whipple surgery improves the survival rate of the patient.

What Is Whipple Surgery?

Whipple surgery is a complex procedure used to treat pancreatic cancer. During the procedure, the surgeon removes the head of the pancreas, part of the bile duct, duodenum (a part of the small intestine), and gallbladder. The procedure usually takes 4–12 hours. The patient has to stay in the hospital for at least ten days or more.

The main aim of this surgery is to prevent the cancer from spreading to other parts. Research says that only 20 per cent of people diagnosed with pancreatic cancer are eligible for Whipple surgery. If the cancer has already spread, then your Whipple surgery is of no use.

Indications That May Lead To Whipple Surgery

• Yellowing of skin and eyes.
• Loss of appetite.
• Unexplained weight loss.
• Abdominal pain.
• Fatigue.
• Indigestion.
• Bloating.
• Fever.
• Itching.

When Whipple Surgery Is Needed?

Your doctor may recommend Whipple surgery if you have one of the health conditions listed below.

• Pancreatic cysts.
• Bile duct cancer.
• Small intestine cancer.
• Inflammation in the pancreas.
• Major injury to the pancreas, duodenum, or nearby organs.
• Neuroendocrine cancer.
• Cancer on the ampulla of Vater (bile duct and pancreatic duct).

How To Prepare For Whipple Surgery?

• You must undergo various tests to ensure you are fit for the Whipple surgery. For example, you must do blood tests, imaging scans to assess tumour size, and an echocardiogram to check your heart health.
• You need to inform your doctor about all the drugs or herbal supplements.
• You must stop taking certain medications like blood thinners a few days before the surgery.
• Ask your doctor all the queries you have related to surgery.
• You will be given a consent form. Read all the benefits and risks associated with the surgery and then sign it. If you have any questions, then ask your doctor. 
• Do not eat or drink anything for 8 hours before going to the hospital for surgery. 
• Take assistance from your friend or family member while coming to the hospital on the date of surgery.

Whenever you enter the hospital, the nurse will put a needle and tube in your arm, which is otherwise known as an intravenous line (IV line). The IV line makes it easier to put fluid or any medication before and during the surgical procedure. The doctor may put a numb drug on your spine to get you ready for the surgery.

What Happens During the Whipple Procedure?

The Whipple surgical procedure can be of various types, which are listed below.

Open Surgery

In this surgery, the surgeon cuts your abdomen and reaches the pancreas to remove the tumours.

Laparoscopic

Here, the surgeon will make various cuts in the abdomen. The doctor will use a laparoscope (a thin tube with a camera) and a few tools to perform the surgery.

Today, laparoscopic surgery is becoming more popular. Here, the doctor will make numerous small incisions and then insert the camera in one such incision. It provides a detailed view of the interior organs. The doctor accordingly decides where to operate during the surgery. 

Robotic Surgery

Here, the surgeon will make various small cuts in your abdomen, just like a laparoscopic procedure. The robotic system gives a detailed and magnified view of the pancreas and other surrounding organs.

Laparoscopic and robotic surgery are minimally invasive surgeries. The benefit of these surgeries is that you have to stay in the hospital for only a few days. There will be less blood loss during the surgery. You will also recover quickly after the surgical procedure, and there will be even fewer complications.

Now, let's discuss the open procedure done during the Whipple surgery.

• You will be the first to be given anaesthesia, which will put you to sleep during the surgical procedure.
• One of the surgical members will put in a urinary catheter to drain pee during the surgical procedure.
• The surgeon will make a large cut in your abdomen to reach the pancreas and other surrounding organs.
• Your surgeon will now check the lymph nodes and organs in the abdomen to check the spread of cancer. The tissue is sent for biopsy.
• The surgeon will then remove the tumour, its surrounding tissues, and nearby lymph nodes, duodenum, gallbladder, and pylorus.
• The remaining part of the stomach is now attached to the jejunum.
• The remaining bile duct and pancreas are also attached to the jejunum. It allows bile and pancreatic juice to flow more easily through the jejunum, neutralizing stomach acid and preventing tumours from growing in such areas shortly.

Modified Whipple Procedure

The procedure is almost the same as the above. However, the pylorus part is not removed during the surgical procedure.

• Your surgeon will remove the same organs as done in the Whipple surgery except for the pylorus.
• The remaining duodenum will be attached to the jejunum.
• The remaining bile duct and pancreas will be attached to the jejunum.

Whipple Procedure Recovery Time

You need to stay in the hospital for almost a week or more after the surgery. You will directly wake up in a special recovery room after the long hours of surgery. The nurse will check your health condition, and if everything is normal, they will transfer you to the general room. 

Your doctor will provide you with certain medications, including painkillers, to recover faster. The urine catheter and drainage tubes will be removed within a few days.

Most people can go home after the remaining few days in the hospital. However, older adults or people with chronic health issues need to go to rehabilitation centres for early recovery. You will be given fluid intravenously for a few days. 

You will then be introduced to clear fluids. Later, solid foods will be introduced. You have to take easily digested food during the first few days after the surgery. Your doctor may recommend taking pancreatic enzyme medication to break food inside your food. 

Diarrohea is a very common problem that is seen in most patients. It may continue for almost 2–3 months.

Some portion of the pancreas is removed from your body, so the pancreas cannot function properly for a few days after the surgery. It cannot produce enough insulin so the doctor can recommend insulin injections.

You have to take these injections until the pancreas produces the proper amount of insulin after surgery.

You can resume all your normal activities after 2-3 weeks of surgery. However, the time it takes to recover entirely depends on your overall health condition and the type of surgery.

Side Effects 

You will observe some side effects after a few days of the surgery. Some patients can be followed one or two months after the surgery. Well, the side effects come and go on their own. But sometimes, certain side effects can remain permanent.

Here is a list of some side effects or complications associated with the surgery.

Pain

You will experience pain after the surgery. Your doctor will provide pain relief medicine.

Infection

Infection is a common side effect in most patients. Your doctor will prescribe antibiotics to treat it.

Bleeding

If you have a blood clotting disorder, you may have bleeding. If blood vessels are not sealed properly during the surgical procedure, bleeding can also occur.

Delayed Gastric Emptying

Food may stay in the stomach for a longer time than normal. You may feel nausea and vomiting. Your stomach will remain full for many hours. This symptom will last for 4 to 12 weeks after the Whipple surgery.

Malabsorption

You may have difficulty absorbing fats, sugar, and other nutrients from food. It can result in bloating and gas problems, and you may also develop vitamin deficiency.

Latose Intolerance

Some patients may have lactose intolerance issues, which means their bodies cannot digest lactose. However, the symptoms will last for a few months after the surgery.

Dumping Syndrome

When food moves very quickly from the stomach to the small intestine, this is known as dumping syndrome. Some patients may face this issue after surgery.

Success Rate of the Whipple Surgery

Unfortunately, only 20 to 25 per cent of patients having Whipple surgery survive for five years. The surgeon no doubt removes the cancerous cells from the pancreas or surrounding organs. But still, cancerous cells have a high chance of spreading again.

How can medical tourism help in Whipple Surgery?

Healthcare costs are increasing globally. Medical tourism has become a boon for many patients all over the world. Countries like India attract international patients because of advanced treatments and good care at low cost.

Racure Health Care is a reputed medical tourism company. The company relationship manager will answer all your queries related to travelling or choosing a hospital for Whipple surgery. 

The company arranges a virtual meeting with the doctor, and you can ask about the surgery, medication, and recovery time. Racure HealthCare even assists you in booking flights and ensures that you travel to your destination without any problem. 

You can choose hotels or guesthouses to stay in according to your preferences. The company appoints a personal care executive who will always be there to help you.

Racure Health Care provides other services, including Whipple Surgery. Visit its website to learn more about the company.

Conclusion

Whipple surgery is mainly done for treating pancreatic cancer. However, it can treat other conditions too, like cancer in the bile duct, duodenum, and ampulla of the water. The surgery can help a patient to live for a longer period. You can do your daily activities after a few days of the surgery. However, the surgery is quite complex and has risks like dumping syndrome and malabsorption.

Racure Healthcare provides treatment-related services as well as travel and logistics services. Contact this medical tourism company today to have hassle-free Whipple surgery.