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(Pancreaticoduodenectomy; Classic Whipple; PP Whipple; Pylorus-preserving Pancreaticoduodenectomy; Pylorus-preserving Whipple Procedure)
A Whipple procedure is complex surgery to remove part of the pancreas along with the:
Reasons for Procedure TOP
Possible Complications TOP
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Complications that occur as a result of surgery may include:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications. such as:
What to Expect TOP
Prior to Procedure
Before surgery, your doctor may do the following tests:
You may be put on a special diet before the surgery to help your body prepare. If you are not able to eat, you may need to go to the hospital several days before surgery. You will be given glucose and fluids through an IV.
Talk to your doctor about your medications, herbs, and dietary supplements. You may be asked to stop taking some medications up to one week before the procedure.
General anesthesia will be used. It will block any pain and keep you asleep during surgery.
Description of the Procedure TOP
For open Whipple procedures, a large incision will be made in the abdomen. The head of the pancreas and the gallbladder, duodenum, and pylorus will be removed. Nearby lymph nodes may also be removed. The remaining pancreas and digestive organs will be reconnected. This will allow the digestive enzymes from the pancreas and stomach contents to flow into the small intestine. In some cases, the pylorus is not removed. The incision will be closed with stitches or staples. The incisions will be covered with bandages.
For laparoscopic procedures, a camera and small surgical instruments are inserted through small incisions into the abdomen. The organs can be removed and reconnected through the openings. After the area is carefully examined, the laparoscope will be removed. The incision will be closed with stitches or staples. The incisions will be covered with bandages.
You may have many small tubes placed after the procedure. Some will help drain fluid from the surgery site. Another tube may go through your nose into your stomach to help prevent nausea and vomiting. A tube may go to your intestines so you can receive nutrition.
Immediately After Procedure TOP
After surgery, you will stay in the intensive care unit for several days. This will help the doctors and nurses monitor your progress.
How Long Will It Take? TOP
How Much Will It Hurt? TOP
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital Stay TOP
You will need to stay in the hospital until your intestines begin to work again. This usually takes 2 weeks. You may need to stay longer if there are any problems.
Post-procedure Care TOP
At the Hospital
During surgery, your doctor may have placed a jejunostomy tube (j-tube). You will receive nutrients through this tube until your intestines are working normally. After the tube is removed, you can gradually progress to a soft diet, then to regular food.
Other tubes will be removed as you recover.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
This surgery will affect the way your body digests food. You may feel bloated or full after eating. You may have nausea and vomiting. Talk to your doctor or dietitian to learn how you should eat. Follow your doctor's instructions.
Call Your Doctor TOP
Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:
If you think you have an emergency, call for medical help right away.
National Cancer Institute
Pancreatic Cancer Action Network
Canadian Cancer Society
Pancreatic Cancer Canada
Halgreen H, Pedersen NT, Worning H. Symptomatic effect of pancreatic enzyme therapy in patients with chronic pancreatitis. Scand J Gastroenterol. 1986;21(1):104.
Nutrition following pancreatic surgery. Pancreatic Cancer Action Network website. Available at: https://www.pancan.org/section-facing-pancreatic-cancer/learn-about-pan-cancer/diet-and-nutrition/after-a-whipple-procedure. Accessed March 6, 2018.
Pancreatic cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114527/Pancreatic-cancer . Updated January 22, 2018. Accessed March 6, 2018.
Singh VV, Toskes PP. Medical therapy for chronic pancreatitis pain. Curr Gastroenterol Rep. 2003;5(2):110.
Surgery for pancreatic cancer. American Cancer Society website. Available at:
What you need to know about cancer of the pancreas. National Cancer Institute website. Available at:
Whipple procedure (pancreaticoduodenectomy). Pancreatic Cancer Action Network website. Available at: https://www.pancan.org/section-facing-pancreatic-cancer/learn-about-pan-cancer/treatment/surgery/whipple-procedure-pancreaticoduodenectomy. Accessed March 6, 2018.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T905141/Treatment-for-tobacco-use : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
Last reviewed March 2018 by
EBSCO Medical Review Board
Alan Drabkin, MD
2545 Park Plaza
Telephone: (615) 344-6060
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