What is it? What are the complications? And what is the prognosis?

Most Common Whipple Procedure Complications

The Whipple procedure is a complex operation and its results are affected by many factors.

One of these factors is the surgeon’s level of expertise, but in the hands of highly trained and experienced surgeons, the chance of Whipple procedure complications is minimal.

Complication no.1: Pancreatic Fistula

One of the complications during Whipple Procedure is the development of pancreatic fistula. After the tumor is removed from the pancreas, the cut end has to be sutured back to the duodenum to create passageway for the pancreatic juices and enzymes into the digestive tract. In some cases, the created passageway does not heal very well, it becomes faulty, and pancreatic juices begin to leak.

This complication occurs in about 4% of Whipple procedures, but the leaking eventually heals on its own. Re-operation is usually unnecessary, a leakage catheter can be sufficient to drain the pancreatic juices.

Complication no.2: Pancreatitis

Another possible complication is inflammation of the pancreas. The incision or the remaining parts of the pancreas may be infected and inflamed. Although not to be taken lightly, this can usually be managed with anti-inflammatory and anti-pyretic drugs and antibiotics.

Complication no.3: Delayed Gastric Emptying

Another Whipple procedure complication is delayed gastric emptying, due to paralysis of the stomach. Standard surgery procedure is to give patients intravenous fluids and withhold oral feeding for the first five to six post-surgical days. This is done to give the bowels sufficient time to heal and recover.

After the rest period, patients are started on a clear liquid diet. They are slowly allowed to progress to a regular diet. By this time, the stomach is expected to contract and move food down to the intestines.
To assist in the patient’s nourishment, osterized food is given through a small feeding tube, which bypasses the stomach and ends in the intestines. In 4-6 weeks, almost all patients’ stomach functions return to normal.

In around 15% to 25% of Whipple procedure patients, the stomach remains paralyzed and requires more time to adapt and return to its normal function. A regular diet is not tolerated since gastric emptying is not at its normal rate.

The Whipple procedure is an answer to the many prayers of pancreatic cancer patients. However, it doesn’t come without risks and the need for a long recovery time. To minimize the possibilities of Whipple procedure complications, it is important to ascertain the medical center’s performance rates and the surgeon’s level of expertise.