The Whipple procedure is named after Dr. Allen Whipple who first performed the surgery in 1935. Surgeons in Italy and Germany had attempted the technique, but Dr. Whipple's refinements took hold as a new standard for treating cancerous tumors that occur at the head of the pancreas. He — and other surgeons including Froedtert & MCW pancreatic cancer surgeon Douglas Evans, MD, FACS — have made numerous improvements to the technique.

During the procedure, surgeons remove the head of the pancreas, the gallbladder, and parts of the bile duct and small intestine. Each case is different, but the surgery can last up to six hours and is one of the most complex operations in the world. After the tumor is removed, the organs are reattached so patients can resume as much normal function as possible.

Not all patients with pancreas tumors are eligible for the Whipple procedure, but it's one of many treatments that provide hope to families facing a cancer diagnosis.

Download a full set of images and illustrations in a PDF document that describes the operation in detail.

Vein Resection During Whipple Procedure

It is generally felt that surgical resection of the primary tumor is necessary to cure the patient with pancreatic cancer. When vascular resection and reconstruction is performed by experienced surgeons at institutions where such surgery is frequently done, morbidity and mortality are not increased compared to a standard Whipple procedure without vascular resection.

For those patients deemed unresectable due to local tumor extension to adjacent blood vessels, the median survival is 10 to 12 months.

In contrast, if the primary tumor can be resected (to include adjacent vessels when necessary), median survival is 2-3 years and almost one-third of such patients survive 5 years from the time of diagnosis.

All of our patients are evaluated in a multidisciplinary fashion by experts in diagnostic radiology, gastroenterology, medical oncology, radiation oncology, and surgery. For the pancreatic cancer patient, surgery is just one part of a successful treatment program. Additional information can be found in the references which are available in PDF format on our Web site.

References

The above is a contribution from Douglas B. Evans, MD and Kathleen Christians, MD.

Von Hoff DD, Evans DB, Hruban RH. Pancreatic Cancer. Sudbury, MA: Jones and Bartlett, 2005.
Katz MHG, et al. Anatomy of the superior mesenteric vein with special reference to the surgical management of first-order branch involvement at pancreaticoduodenectomy. Ann Surg. 2008;248(6):1098-102.
Tseng, et al. Pancreaticoduodenectomy with vascular resection: margin status and survival duration. J Gastrointest Surg 2004;8:935-49.