What is Whipple Procedure
Whipple procedure is a surgery to remove the head of the pancreas, the upper part of the small intestine (duodenum), and the organ that stores fluid (bile) made in the liver (gallbladder). Part of the stomach may also be removed during this procedure. The pancreas is a large gland located behind the stomach. It helps digest food, and it produces hormones that regulate blood sugar. The head of the pancreas is the part that is connected to the duodenum. A Whipple procedure may be necessary because of a pancreas infection (chronic pancreatitis) or pancreatic cancer.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have, such as diabetes.
- Whether you are pregnant or may be pregnant.
What are the risks?
Generally, this is a safe procedure. However, problems may occur, including:
- Bleeding and blood clots.
- Allergic reactions to medicines.
- Damage to other structures or organs.
- Fluid leaking from the newly formed connection between the pancreas and the small intestine (pancreatic leak).
- Loss of appetite. This may lead to weight loss.
- Low levels of digestive enzymes. This means that you may have trouble digesting food at a normal rate.
What happens before the procedure?
may have tests, including:
- Blood tests.
- Electrocardiogram (ECG).
- Follow instructions from your health care provider about eating or drinking restrictions.
- You may be given antibiotic medicine to help prevent infection.
- Ask your health care provider how your surgical site will be marked or identified.
your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
- Plan to have someone take you home after the procedure.
- If you go home right after the procedure, plan to have someone with you for 24 hours.
What happens during the procedure?
- An IV tube will be inserted into one of your veins.
- You will be given a medicine to make you fall asleep (general anesthetic). You may also be given a medicine to help you relax (sedative).
- A tube may be inserted through your nose and into your stomach (nasogastric tube). The nasogastric tube removes digestive fluids and prevents you from throwing up or feeling nauseous.
- A small, flexible tube (catheter) will be inserted into your bladder to measure your urine production during surgery.
- An incision will be made in the upper part of your abdomen.
- The head of your pancreas, your duodenum, and your gallbladder will be removed. Part of your stomach may also be removed.
- Your pancreas, your stomach, and the main tube that carries fluid (bile) from your liver (common bile duct) will all be connected to your small intestine with stitches (sutures).
may be inserted in your incision, such as:
- A drainage tube. This drains excess fluids from your abdomen.
- An intestinal feeding tube. This provides you with food after surgery until you are able to eat normally.
- Your incision will be closed with sutures, skin glue, or adhesive tape.
- Your incision will be covered with a bandage (dressing).
The procedure may vary among health care providers and hospitals.
What happens after the procedure?
- You may continue to receive fluids and medicine through an IV tube.
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
- You will have some pain, and you may feel nauseous. Medicine will be available to help you.
- You may have one or more of the following:
- A catheter draining urine from your bladder.
- A drainage tube coming from your incision.
- An intestinal feeding tube coming from your incision.
- A nasogastric tube.
- You may have to wear compression stockings. These stockings help prevent blood clots and reduce swelling in your legs.
- You may not be able to eat solid food for up to several days after surgery.
- You may be taught breathing exercises to help prevent lung infections.
- Do not drive for 24 hours if you received a sedative.
Whipple Procedure, Care After
Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.
What can I expect after the procedure?
After the procedure, it is common to have:
- Abdominal pain.
- Nausea and difficulty digesting food.
- A small amount of blood or clear fluid draining from your incision.
- Decreased appetite.
Follow these instructions at home:
- Take over-the-counter and prescription medicines only as told by your health care provider.
- Do notdrive or operate heavy machinery while taking prescription pain medicine.
- If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if you start to feel better.
Incision and drainage tube care
- Keep your incision area and drainage tube opening clean and dry.
your incision area every day for signs of infection. Check for:
- More redness, swelling, or pain.
- More fluid or blood.
- Pus or a bad smell.
instructions from your health care provider about how to take care of your
incision. Make sure you:
- Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
- Change your dressing as told by your health care provider.
- Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips completely unless your health care provider tells you to do that.
you have a drainage tube, follow instructions from your health care
provider about how to care for it.
- Do notremove the tube yourself.
- Change the dressing around the tube as told by your health care provider.
- Write down how much fluid drains each day. Note any changes in how the fluid looks or smells.
- Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
- Walk around at least once every day to reduce the chance of blood clots.
- Do notengage in intense physical activity, such as running or jumping, until your health care provider says that you can.
- Do notlift anything that is heavier than 10 lb (4.5 kg) for 6 weeks or until your health care provider says that you can do this.
Eating and drinking
- Follow instructions from your health care provider about eating or drinking restrictions.
- Eat small meals at least 3 times a day. It is best to eat small portions every 2–3 hours. Do notskip meals, even if you do not feel like eating.
- Avoid foods that contain a lot of fat, such as greasy or fried foods. These can be difficult to digest.
healthy foods, such as:
- Fruits and vegetables.
- Lean proteins, such as tuna, egg whites, chicken, or lean beef.
- Low-fat dairy products.
- High-fiber foods, such as beans, nuts, or whole grains.
- Drink enough fluid to keep your urine clear or pale yellow.
- Do notuse alcohol until your health care provider approves.
- Weigh yourself once a week and write down your weight.
- Wear compression stockings as told by your health care provider. These stockings help prevent blood clots and reduce swelling in your legs.
- Do nottake baths, swim, or use a hot tub until your health care provider approves.
- Do notuse any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
- Keep all follow-up visits as told by your health care provider. This is important.
Contact a health care provider if:
- You are dizzy.
become constipated. Signs of constipation may include having:
- Fewer than three bowel movements in a week.
- Difficulty having a bowel movement.
- Stools that are dry, hard, or larger than normal.
- You are unusually thirsty or unusually tired, and these feelings do not go away.
- You urinate more often than usual.
- You have nausea that does not go away.
- You have pain that gets worse or does not get better with medicine.
- You have diarrhea.
- You have more redness, swelling, or pain around your incision.
- You have more fluid or blood coming from your incision or your drainage tube.
- Your incision feels warm to the touch.
- You have pus or a bad smell coming from your incision.
- You have a fever.
- You have fluid coming from your drainage tube that changes color or smells bad.
Get help right away if:
- You are unable to eat.
- You vomit.
- You have severe pain.
- You have severe constipation or diarrhea.
- Your incision starts to open.
- You have chest pain.
- You have difficulty breathing.