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Whipple Procedure Complications

written by: Diana Cooper • edited by: Leigh A. Zaykoski • updated: 7/13/2010

The Whipple procedure is a complicated surgery but if performed by an experienced surgeon, problems are normally minimal. Find information on this operation and know what Whipple procedure complications can occur.

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    Whipple Procedure

    Stomach, Gall Bladder, Pancreas, and Duodenum The Whipple procedure (also called a pancreatico- duodenectomy) was first described by Allan Whipple in the 1930s. It involves removing the head of the pancreas, part of the bile duct, the gallbladder, the duodenum (the first part of the small intestine), and sometimes a portion of the stomach. After the removal of these structures, the surgeon reconnects the remaining pancreas, bile duct, and intestine.

    During the 1960s and 1970s, the mortality rate for this complicated procedure was very high (about 25%). Today, the mortality rate has decreased (less than 5% in hospitals that perform the procedure frequently and about 15-20% in hospitals that perform it infrequently). If there are no Whipple procedure complications, the average hospital stay is 14 days.

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    Whipple Procedure Complications

    If the surgeon has limited experience with this complex operation, the chances of developing complications are high. If the surgeon is experienced, the risks of developing problems are usually very low. Complications can include:

    Leaking Pancreatic Juice

    The pancreas is a soft organ. Because of this, the suture line (from reconnecting it) may not heal very well. This can cause pancreatic juice to leak out. Usually a catheter is placed to catch the drainage. In most patients who have this complication, the leakage heals on its own.

    Delayed Bowel Function

    After the procedure, bowel function must be returned to normal. The patient will go without eating or drinking for about the first 5 to 6 days (while receiving intravenous fluids) and, if bowel function is returning as expected, he or she will slowly progress to a regular diet. Most people regain complete bowel function after a few days. However, some can take up to 4 to 6 weeks to fully recover. If this was to occur, nutrition is normally obtained through a feeding tube.

    Decreased Pancreatic Enzymes

    The pancreas is responsible for producing enzymes that are needed to digest food. Some people may not be able to produce a sufficient amount of these enzymes after the Whipple procedure. This can affect the absorption of nutrients and cause the person's stool to be diarrhea-like and very oily. If this was to occur, pancreatic enzyme supplementation is needed.

    Weight Loss

    On average, patients lose about 5 to 10% of their pre-operative body weight after the procedure. Most are able to regain it once they are able to eat regularly.

    Diabetes

    Developing diabetes is possible since the pancreas contains insulin-producing cells. However, if the person had normal blood sugar prior to the operation, this Whipple procedure complication is unlikely.

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    Sources Used

    Mayo Clinic: Pancreatic Cancer - Whipple Procedure -

    http://www.mayoclinic.org/pancreatic-cancer/whippleprocedure.html

    University of Southern California, Department of Surgery: Whipple Operation - http://www.surgery.usc.edu/divisions/tumor/pancreasdiseases/web%20pages/pancreas%20resection/whipple%20operation.html

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    Photo Credit

    Image courtesy of http://commons.wikimedia.org/wiki/File:Pancreas_nih.jpg