Whipple Procedure: Will It Cure Pancreatic Cancer?

Medically Reviewed by Zilpah Sheikh, MD on December 20, 2023
8 min read

A Whipple procedure is the main surgery used to treat tumors in the head of the pancreas. Also called a pancreaticoduodenectomy, it’s named after Allen Whipple, MD, a Columbia University surgeon. In 1935, he became the first American to perform the operation.

Among common cancers, pancreatic cancer has one of the poorest prognoses. Because pancreatic cancer often grows and spreads long before it causes any symptoms, only about 6% of people who are diagnosed live 5 years after diagnosis.

If you have cancer in your pancreas or nearby organs, the Whipple procedure may be the only way to extend your life and potentially cure you. Those who undergo a successful Whipple procedure may boost their 5-year survival rate up to 25%.

The Whipple procedure involves removing the head (wide part) of the pancreas, which is connected to the top part of the small intestine (duodenum). Your doctor may also take out the:

  • Duodenum
  • Lymph nodes around the pancreas
  • Common bile duct
  • Gallbladder
  • Part of the stomach (sometimes)

Surgeons reconnect the small intestine, bile duct, and pancreas after they remove tumors or other damaged tissue.

About 20% of people withpancreatic cancer are eligible for the Whipple procedure and other surgeries. These are usually people whose tumors are confined to the head of the pancreas and haven’t spread to nearby major blood vessels, or the liver,lungs, or abdominal cavity. Intensive testing is usually necessary to identify possible candidates for the Whipple procedure.

Most people who get this operation have pancreatic cancer. But the Whipple procedure is sometimes used to treat health conditions such as:

  • Pancreatic cysts
  • Inflammation of the pancreas (pancreatitis)
  • Cancer in your upper small intestine
  • Damage to your pancreas or small intestine
  • Cancer between the bile and pancreatic ducts (ampullary cancer)
  • Bile duct cancer
  • Neuroendocrine tumors

The Whipple procedure isn't an option for the 40% of newly diagnosed people whose tumors have spread (metastasized) beyond the pancreas. Only rarely is it an option for the 40% of patients with locally advanced disease that has spread to adjacent areas such as the superior mesenteric vein and artery, or for those whose tumors have spread to the body or tail of the pancreas.

You’ll meet with your surgeon ahead of time to go over the next steps. This is a good time to bring up any concerns or ask about how the procedure may affect your life.

If you have cancer, you may need treatment with radiation or chemotherapy before your operation. When you get a date for your Whipple procedure, you’ll need to stop taking certain medications and herbal supplements. Your doctor will let you know which ones.

The day before you go to the hospital, you may need to:

  • Stop eating or drinking 8 hours before you go to the hospital.
  • Not take medication for erectile dysfunction (such as Viagra).
  • Take your blood pressure medication (with a small sip of water).
  • Make sure you have a ride home from a friend or family member.

Once you get to the hospital, a nurse will put a needle and tube into a vein in your arm. You may hear this called an intravenous (IV) line. The IV makes it easier for your health care team to put fluids and medication into your arm before or during surgery. Your doctor may put a numbing drug in your spine. Also called an epidural catheter, this spinal shot can lessen post-surgery pain.



There are a few different ways to do the Whipple procedure. The types of surgery offered include:

  • Open. Most of the time, surgeons make one long cut in your abdomen to get to the pancreas or nearby organs.
  • Laparoscopic. This is a type of minimally invasive surgery. Your surgeon makes several small cuts in your abdomen. A tiny camera goes through one of the incisions to show the doctor where to operate. They put their surgical tools through the other cuts.
  • Robotic. This is another kind of minimally invasive surgery. Your surgeon guides a surgical “robot” using a console and a camera. The robotic arms hold the tools, but your doctor controls everything through images they see on a zoomed-in screen.

Compared to an open surgery, a laparoscopic or minimally invasive procedure may result in less blood loss, a shorter hospital stay, a quicker recovery, and fewer complications.

You’ll get general anesthesia during surgery. This is a type of medication that puts you to sleep. When you’re no longer awake, someone on your surgical team will put a tube into your bladder. This is called a urinary catheter, and it’s used to drain your pee during the procedure.

Your surgery may take 4-12 hours, but it depends on what your surgical team needs to do. They may not know how complex your case is until they take a look during the procedure.

Steps of a Whipple procedure:

  1. To get to your pancreas, your surgeon makes one large cut (open surgery) or several small incisions (laparoscopic surgery) in your abdomen.
  2. They take out the part of your pancreas that’s cancerous or damaged. Also removed are the nearby small bowel (duodenum), lower part of the bile duct, gallbladder, and maybe part of your stomach.
  3. The surgeon reconnects your pancreas and bile duct to your small intestine.
  4. The doctor reattaches your stomach and small intestine so food can empty into your gastrointestinal (GI) tract like normal after the surgery.

After surgery, you may need to stay in the hospital for a week or so before returning home. Your doctor will give you prescription or over-the-counter painkillers for any discomfort you may have during recovery. They’ll let you know how often to use these medications.

Right after the procedure, you’ll wake up in a special recovery room. A nurse will check on you before they move you to a general area. During your hospital stay, someone on your health care team will watch for signs of infections or other problems.

Most people can recover at home. But older adults or people with other health issues may need to go to a special rehabilitation facility to get better.

At first, you may only be able to eat small amounts of easily digestible food. You may need to take pancreatic enzymes -- medication that helps you break down food -- on a short-term or long-term basis to assist with digestion. Diarrhea is a common problem during the 2 or 3 months it usually takes for the rearranged digestive tract to fully recover.

You should be able to go back to doing normal activities around 4-6 weeks after surgery. But how long it takes you to recover depends on your overall health and the kind of surgery you have.

Around 1 in 3 people who get this surgery have a complication afterward. Some are mild, while others are more serious. One of the most common things to happen right after the Whipple procedure is the development of false channels (fistulas) and leakage from the site of the bowel reconnection. Infections, bleeding, and slow stomach emptying after meals can also happen after the procedure.

Other possible surgical complications include:

  • Weight loss. Your body may not be able to digest and absorb calories in the same way after surgery. This leads to weight loss in many people who get the Whipple procedure.
  • Diabetes. Your pancreas makes insulin, and you may not be able to control your blood sugar as well if your surgeon removes a big part of this organ. However, you’re less likely to get diabetes if you have normal blood sugar before surgery. And your blood sugar may improve after surgery even if you get diabetes.
  • Malabsorption. Without enough digestive enzymes from your pancreas, you may have trouble absorbing fats, sugars, or other nutrients from food. This can result in bloating, gas, diarrhea, or more frequent bowel movements. You can develop vitamin and mineral deficiencies, so talk to your doctor about supplements.
  • Lactose intolerance. Some people can’t digest lactose after surgery. This may get better a few months after surgery. If it doesn’t, ask your doctor if you need any prescription or over-the-counter medication to help you digest lactose.



Overall, about 20%-25% of people who get the Whipple procedure are alive 5 years after surgery. But even if your surgeon removes the visible tumor, it's possible for cancer cells to spread elsewhere in the body. This can be fatal down the road even if your surgery is successful.

In the past few decades, there have been a lot of improvements in diagnosis, staging, surgical techniques, anesthesia, and postoperative care for the Whipple procedure. As a result, the short-term death rate has dropped to less than 4% in people who get surgery at cancer centers by experienced surgeons. At some major centers, the reported death rate is less than 1%. But it may still be more than 15% for people who get treatment at a small hospital or by less experienced surgeons.

The 5-year survival rate is higher if you have node-negative cancer (when cancer hasn’t spread to nearby lymph nodes) than for people who have node-positive cancer.

Regardless of node status, most people with pancreatic cancer receive chemotherapy, radiation, or both before or after surgery. But cancer specialists have differing opinions on the best combination and the best drugs to use. Recent trials have shown improved outcomes with chemotherapy before surgery and with different chemotherapy regimens before and after surgery.

The Whipple procedure may help people with pancreatic cancer or other cancers live longer; however, it’s a difficult surgery that may come with complications. An experienced surgeon can go over the pros and cons with you and let you know how the operation may change your daily life.

What is the life expectancy of a Whipple surgery?

If you don’t have pancreatic cancer, you may have a normal life expectancy after surgery. People diagnosed with common kinds of advanced pancreatic cancer may live around 2 years afterward. But how long you’ll live depends on why you get the procedure in the first place and how far your cancer has spread.

Can you live a normal life after the Whipple procedure?

You can usually go back to your regular daily activities around 4-6 weeks after surgery. But you may need to take pancreatic enzymes to aid in digestion or make long-term diet changes.

How serious is the Whipple procedure?

This is a very complex operation that should be done by a skilled surgeon. Doctors with experience in the Whipple procedure typically work at big cancer centers.

Why would someone need a Whipple procedure?

Most people who need this surgery get it to remove tumors related to pancreatic cancer. But this operation is sometimes used to treat pancreatic inflammation or cysts along with cancers of the bile duct, small intestine, or nearby organs.