The Whipple procedure (pancreatoduodenectomy) is the most common operation to remove pancreatic cancers. The Whipple procedure may also be used to treat some benign pancreatic lesions and cysts and cancers in the bile duct and beginning part of the small intestine (duodenum).

Read more about pancreatic cancer.

About

The goal of the Whipple procedure (pancreatoduodenectomy) is to remove the head of the pancreas, where most tumors occur. Because the pancreas is so integrated with other organs, the surgeon must also remove the first part of small intestine (duodenum), the gallbladder, the end of the common bile duct and sometimes a portion of the stomach. In the reconstruction phase of the operation, the intestine, bile duct and remaining portion of the pancreas are reconnected.

The Whipple procedure is a difficult and demanding operation for both the person undergoing surgery and the surgeon.

Laparoscopic option

A laparoscopic Whipple procedure may be offered to select individuals. The laparoscopic Whipple procedure is performed through six small incisions in the abdominal wall. A laparoscope, a long thin tube with a lighted camera at its tip, is inserted through one incision. The surgeon operates using specially designed surgical instruments placed through the remaining incisions, guided by the laparoscope images shown on a monitor in the operating room.

At Mayo Clinic, laparoscopic Whipple surgery usually takes four to five hours. Most people leave the hospital in four to six days, compared with eight to 10 days for those who have conventional surgery. One month after a laparoscopic Whipple procedure, most people are able to eat normally, and many can return to work and normal activities.

Mayo Clinic researchers are evaluating the laparoscopic approach to see if the benefits found in other minimally invasive surgeries — less blood loss, shorter hospital stays and faster recovery — also apply in laparoscopic Whipple surgery.

Complications

The most common post-surgical complication of pancreatoduodenectomy is leaking of pancreatic juices from the incision. If this occurs, a drain may be inserted through the skin to allow drainage for several weeks after surgery. Weight loss is another frequent complication of the Whipple procedure. Diabetes is a potentially serious concern for some people (a minority) after surgery. In general, although many people do very well after the Whipple procedure, some develop immediate complications that affect their quality of life.

To help ensure an uncomplicated recovery, Mayo Clinic specialists provide nutrition counseling and ongoing supportive care.

  • Experience. Mayo Clinic surgeons are among the most experienced in the world in this complex procedure, performing approximately 120 Whipple operations and about 775 pancreatic operations each year.
  • Access to latest developments. Mayo Clinic is a leader in advancements of the Whipple procedure to improve recovery, quality of life and cancer outcomes. Mayo Clinic is a leader in the minimally invasive (laparoscopic) approach to the Whipple procedure and is one of the few medical centers offering the laparoscopic approach.
  • Teamwork. In Mayo Clinic's multidisciplinary team approach to patient care, you benefit not only from your surgeon's skill but also from the experience and expertise of the entire team involved in caring for you.
  • Comprehensive cancer center. Mayo Clinic Cancer Center meets strict standards for a National Cancer Institute comprehensive cancer center, recognizing scientific excellence and a multispecialty approach focused on cancer prevention, diagnosis and treatment.

Mayo Clinic in Rochester, Minn., and Mayo Clinic in Scottsdale, Ariz., are ranked among the Best Hospitals for cancer by U.S. News & World Report. Mayo Clinic in Jacksonville, Fla., is ranked high performing for cancer by U.S. News & World Report.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

Why Choose Mayo Clinic

What Sets Mayo Clinic Apart

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

The Whipple procedure is performed by doctors in general surgery. Digestive disease specialists from the Pancreas Clinic at Mayo Clinic in Arizona also participate in evaluation and care.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Mayo Clinic in Florida is experienced in performing pancreatic surgery. Surgeons in general surgery have a national reputation for expertise in performing the Whipple procedure. You are cared for by a multispecialty team that includes specialists in gastroenterology, hematology/oncology, radiation oncology, radiology and other areas, who work closely together to see that you receive optimal care.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Surgeons in gastroenterologic and general surgery are among the most experienced in the world in performing the Whipple procedure. Mayo's integrated team of pancreatic cancer specialists — from gastroenterology and hepatology, oncology, radiation oncology, radiology and other areas — meet every day to care for patients.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Surgeons at Mayo Clinic have the largest, single-institution experience with laparoscopic distal pancreatectomy, used to remove tumors in the body and tail of the pancreas. Mayo Clinic studies have shown that for most people, laparoscopically surgery results in shorter operating times, less blood loss, shorter hospital stays and faster recovery than does conventional surgery. Mayo Clinic surgeons are now doing research to document the results for laparoscopic Whipple surgery.

Mayo Clinic surgeons are also actively involved in the Mayo Clinic Cancer Center Gastrointestinal (GI) Program, which is dedicated to advancing scientific knowledge of cancers affecting the intestinal tract and to improving the quality of life of people affected by these diseases. Research activities focus on eight different disease sites, including the pancreas, bile duct and small bowel.

Publications

See a list of publications by Mayo Clinic authors on the Whipple procedure (pancreatoduodenectomy) on PubMed, a service of the National Library of Medicine.

Jul. 17, 2012