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Whipple Procedure

The most common surgery for cancer of the pancreas is called the Whipple procedure, or pancreaticoduodenectomy.

It also can be performed for cancer of the common bile duct and the duodenum, which is the first 10 inches of the small intestine.

Our UCI Health pancreas surgeons are among the nation's most experienced at performing Whipple procedures successfully.

What is the Whipple procedure?

The procedure involves removal of the head of the pancreas, the gallbladder, the duodenum, part of the stomach, part of the common bile duct and associated lymph nodes.

Once these are removed, the pancreatic duct, the remaining parts of the stomach, pancreas and bile duct are connected to the second portion of the small intestine, called the jejunum. This reconstructed digestive system allows pancreatic juices, bile and food to pass through the body.

During the surgery, pathologists examine tissue samples for cancer cells. These results, called frozen section, are given to the surgeon during the operation. Final pathology results can take up to two weeks.

For more information about the Whipple procedure or to schedule a consultation, please call us at 888-717-4463 or complete our online appointment request form ›

The Whipple procedure, which is also performed for some benign pancreas conditions, is one of the most complex and demanding surgeries in medicine, taking six to 12 hours to complete. In general, patients undergoing this type of surgery fare better at a hospital where at least 10 of the procedures are performed each year.

Our pancreas specialists at UCI Health perform about 60 Whipple surgeries a year. Dr. David K. Imagawa is a leader in minimally invasive approaches to pancreas surgery. His expertise in managing patients with liver and pancreatic cancers draws patients from throughout the West Coast.

The most common complication after the Whipple is delayed gastric emptying, meaning that the stomach takes too long to empty its contents into the small intestine.

Traditionally, the stomach takes seven to 10 days to begin working and moving contents properly after the operation. With this complication, it may take a few weeks for the stomach to pass food efficiently. 

Another common complication is infection, which can be managed with drains, antibiotics and proper nutrition.

Less common complications may include bleeding, injury to surrounding structures, leaks at the reconnection sites, diabetes, abscesses, ulcers, wound infections, sepsis, pneumonia, deep venous thrombosis (DVT), pulmonary embolism (PE), kidney failure, heart attack, stroke or even death. 

Our UCI Health hepatobiliary surgeons are among the most experienced in the nation at performing this complex procedure. In high-volume hospitals such as UC Irvine Medical Center, the published mortality rate is 1 percent to 5 percent. In low-volume centers, the mortality rate can exceed 20 percent.

A blood transfusion is a real possibility for patients undergoing a surgery of the magnitude of the Whipple procedure.

Our comprehensive screening of all UCI Health blood products before use makes the risks associated with transfusions very low.

However, if you are concerned, please discuss your options with us. You may be able to donate your own blood prior to surgery.

Our pancreatic cancer specialists are part of a multidisciplinary UCI Health team that includes physicians who are experts in pain management.

Our pain management specialists are experts at finding the best methods to manage your pain after surgery and to assess your coping and pain medication tolerance daily.

If long-term pain management is needed, a palliative care specialist may be consulted.

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