Our Summary

Pancreatic cancer is one of the deadliest forms of cancer. Two surgical treatment options exist: the classic Whipple (CW) operation and the pylorus-preserving pancreaticoduodenectomy (PPW). Researchers conducted a study to determine which method was more effective in terms of survival rates, complications, and quality of life after surgery. They examined data from eight previous trials involving a total of 512 patients. The results showed no significant differences in postoperative mortality, overall survival, and complications between the two methods, except for delayed gastric emptying, which was less likely in the CW method. However, several measures related to the surgery itself, like operating time, blood loss and need for blood transfusion, were significantly better in the PPW method. Despite these findings, the quality of the evidence was considered low, and the researchers concluded that more high-quality trials are needed to definitively determine which method is better.

FAQs

  1. What are the two surgical treatment options for pancreatic cancer?
  2. Did the study find any significant differences in outcomes between the classic Whipple operation and the pylorus-preserving pancreaticoduodenectomy?
  3. What were the findings related to the surgery itself, like operating time and blood loss, for the two methods?

Doctor’s Tip

After a Whipple procedure, it is important to follow your doctor’s instructions for post-operative care closely. This may include taking medications as prescribed, following a special diet, and attending follow-up appointments. It is also important to watch for signs of infection or other complications and to contact your doctor if you experience any unusual symptoms. By taking good care of yourself after surgery, you can improve your chances of a successful recovery.

Suitable For

Patients typically recommended for a Whipple procedure include those with pancreatic cancer, tumors in the head of the pancreas, bile duct cancer, and certain types of benign tumors and cysts in the pancreas. It is important for patients to undergo a thorough evaluation by a multidisciplinary team to determine if they are suitable candidates for the surgery.

Timeline

Before Whipple procedure:

  1. Patient is diagnosed with pancreatic cancer through imaging tests, blood tests, and possibly a biopsy.
  2. Patient undergoes preoperative evaluations to assess fitness for surgery.
  3. Patient may undergo chemotherapy or radiation therapy to shrink the tumor before surgery.

After Whipple procedure:

  1. Patient undergoes a lengthy surgery to remove the head of the pancreas, part of the small intestine, gallbladder, and sometimes part of the stomach.
  2. Patient experiences a hospital stay of 1-2 weeks for recovery.
  3. Patient may experience complications such as infection, bleeding, or delayed gastric emptying.
  4. Patient undergoes a period of healing and adjustment to changes in digestion and diet.
  5. Patient may undergo chemotherapy or radiation therapy after surgery to reduce the risk of cancer recurrence.

What to Ask Your Doctor

Some questions a patient should ask their doctor about the Whipple procedure include:

  1. What is the purpose of the Whipple procedure?
  2. Am I a candidate for the Whipple procedure?
  3. What are the risks and potential complications associated with the Whipple procedure?
  4. What is the recovery process like after the Whipple procedure?
  5. How long will I need to stay in the hospital after the Whipple procedure?
  6. What is the long-term outlook for patients who undergo the Whipple procedure?
  7. Are there any alternative treatment options to the Whipple procedure?
  8. How many Whipple procedures have you performed, and what is your success rate?
  9. What will my quality of life be like after the Whipple procedure?
  10. Are there any lifestyle changes I will need to make after the Whipple procedure?

Reference

Authors: Hüttner FJ, Fitzmaurice C, Schwarzer G, Seiler CM, Antes G, Büchler MW, Diener MK. Journal: Cochrane Database Syst Rev. 2016 Feb 16;2(2):CD006053. doi: 10.1002/14651858.CD006053.pub6. PMID: 26905229