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Whipple Procedure

What Are Complications of the Whipple Procedure?

Immediately after the Whipple procedure, serious complications affect up to one-third of patients. One of the most common of these include the development of false channels (fistulas) and leakage from the site of the bowel reconnection. Other possible surgical complications include: 

  • Infections
  • Bleeding
  • Trouble with the stomach emptying itself after meals 

After surgery, patients are usually hospitalized for a week before returning home. Because recovery can be slow and painful, they usually need to take prescription or over-the-counter pain medications

At first, patients can eat only small amounts of easily digestible food. They may need to take pancreatic enzymes -- either short-term or long-term -- to assist with digestion. Diarrhea is a common problem during the two or three months it usually takes for the rearranged digestive tract to fully recover. 

Other possible complications include: 

  • Weight loss. Most patients can expect to lose about 7% of their weight.
  • Diabetes.This condition can develop if too many insulin-producing cells are removed from the pancreas. However, patients who have normal blood sugar before surgery are unlikely to develop diabetes, and those who recently developed diabetes before surgery are even likely to improve.

 

Prognosis After the Whipple Procedure

Overall, the five-year survival rate after a Whipple procedure is about 20%. Even if the procedure successfully removes the visible tumor, it's possible that some cancer cells have already spread elsewhere in the body, where they can form new tumors and eventually cause death. 

The five-year survival rate is higher (about 25% to 30%) in node-negative patients whose cancers have not spread to nearby lymph nodes than it is in node-positive patients (about 10%). 

Regardless of node status, most patients receive chemotherapy, radiation, or both after surgery. However, cancer specialists have differing opinions on the best combination and the best drugs to use. 

It's not yet known if therapy works better before or after surgery. But some research suggests that therapy could allow a few patients who are initially thought to be ineligible for surgery to eventually undergo the Whipple procedure. Studies are ongoing.   

WebMD Medical Reference

Reviewed by Arnold Wax, MD on September 21, 2012
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