Who Should Perform the Whipple Procedure? continued...
After the Whipple procedure was introduced, many surgeons were reluctant to perform it because it had a high death rate. As recently as the 1970s, up to 25% of patients either died during the surgery or shortly thereafter.
Since then, improvements in diagnosis, staging, surgical techniques, anesthesia, and postoperative care have reduced the short-term death rate to less than 4% in patients whose operation is performed at cancer centers by experienced surgeons. At some major centers, the reported death rate is less than 1%. But the rate may still be above 15% in patients who are treated at small hospitals or by less experienced surgeons.
Because the Whipple procedure continues to be one of the most demanding and risky operations for surgeons and patients, the American Cancer Society says it's best to have the procedure done at a hospital that performs at least 15 to 20 pancreas surgeries per year. The organization also recommends choosing a surgeon who does many such operations.
What Are Complications of the Whipple Procedure?
Immediately after the Whipple procedure, serious complications can affect many 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:
- 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 weight after the surgery.
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.