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the Whipple Procedure is an operation designed to remove a portion of the pancreas (typically
the head of the pancreas), where a majority of the pancreatic cancers originate from.
And it involves moving a part of the pancreas, the head of the pancreas, part of the small
intestines, the gallbladder (if it hasn’t been removed already) and part of the ball
duct. And then performing the reconstruction could take anywhere from five hours to seven
hours, depended on the complexity and prior surgery and prior treatment involved in the
area. So it is a technically challenging operation with a whole set of complications that are
unique to the operation, in which I think the Med Center is fortunate enough to be such
experienced with it, we are adept in dealing with the possible complications and then getting
patients through it.
In the past, the outcomes for this operation were not very good. So 30-40 years ago about
20 percent of the people died after this operation. Now it’s significantly less, but still (in
general speaking) it’s about eight to nine percent in the country. Fortunately, since
we do so many at the Med Center, ours is significantly less, even less than the three percent range.
So we are fortunate; and the reason why that even though the mortality range from the operation
has decreased, the complication rate has not. What has happened, though, is we’ve gotten
very good at dealing with the complications, treating them, patients recover and then get
better. So we’ve gotten very good at dealing with the complications that in the past would’ve
led to serious outcomes such as death possibly. We’re now very good at treating them, to
prevent that and getting patients to the operation.
There have been multiple studies showing it’s advantageous for patients to seek center that
have done a lot of these, because not only is the mortality and the complication rate
loss, but then other things of getting patients through a complication better, and as a whole
team approaching and managing such patients, they’re fortunate that the Med Center has
its reputation and has such a volume that there does a fair number of these operations.
It’s not just the surgeons, it’s the radiologists, it’s the instradectral (?) radiologists,
it’s having good cardiology, good supports in other areas to help them all work together
to get patients through when then have complications.
I think that since this is a major operation, we do like to make patients seek second opinions.
There are often times we are the second or third opinion, but as long as patients go
and seek a qualified opinion about the operation, I think that will be in their best interest.
Typically, the national average is about 14 days. We have found, though, that if patients
go smoothly and things heal well, they could be home in about seven to eight days. But,
still, it’s fair enough to say that you should expect about 10 to 14 days (would not
be an uncommon state). But it could be longer; it could be weeks or even a month or longer,
depending on the severity of the complications that are due to ensue. And it takes about
patients about two to three months for them to typically recover from the operation before
they can safely feel good again.
So we have done quality of life studies on patients who’ve undergone the Whipple operation
and the quality of life scores are typically very very good once they’ve recovered. However
though, of course, we’re still dealing with pancreatic cancer, typically for which is
the number one reason we’re doing the operation for. So there’s still ongoing chemo therapy
and/or radiation therapy that may be ensued and of course the required life may not be
as great if the cancer does return. But in general, for patients who have done good,
cancer does not return. Long-term studies have shown that patients who have undergone
the Whipple operation to have a good quality of life. They do have to watch their diet
and the modifications of or their tilt for their diet, but in general though, a fair
number of patients (the overall majority of patients) have a good quality of life