The Whipple procedure (pancreaticoduodenectomy) is the operation most often used for tumours in the head of the pancreas, and for some tumours of the bile duct and duodenum. It is one of the major operations of abdominal surgery and should be carried out in centres with experience. In this guide New City Clinic explains in general terms what the operation involves; whether it is suitable for you is decided by the tumour board.
What is removed and what is rebuilt?
The head of the pancreas, the duodenum, the lower part of the bile duct and the gallbladder are removed, sometimes together with a small part of the stomach, along with the surrounding lymph nodes. The remaining pancreas, the bile duct and the stomach are then joined to the small intestine so that digestive juices and food can flow again. The removed tissue is examined by pathology, and the result guides the treatment that follows.
Who is suitable?
The key question is whether the tumour can be removed completely. A pancreas-protocol CT scan, and MRI or endoscopic ultrasound where needed, show how the tumour relates to the nearby blood vessels and whether the disease has spread. Some patients are suitable for surgery straight away; in others, drug treatment is given first and surgery is reconsidered afterwards. If jaundice is present, the bile duct may first be opened with a stent. General fitness, heart and lung function are assessed as well.
The operation and the hospital stay
The operation takes several hours. Afterwards you are monitored closely, usually in intensive care for the first day or two, and then on the ward. If recovery is uneventful, the hospital stay is generally one to two weeks. Complications such as leakage from the pancreatic join or slow emptying of the stomach can lengthen the stay; this is one reason why the experience of the team matters. Your surgeon explains the risks that apply to you before you decide.
Life after a Whipple
Most patients eat normally again over time, starting with small, frequent meals. Because part of the pancreas has been removed, many people take enzyme capsules with meals, and blood sugar is monitored, as diabetes can develop or change. Weight loss in the first months is common and is followed up with a dietitian. Drug treatment after surgery is recommended for many patients and can often be continued in your own country.
The Whipple procedure with New City Clinic
New City Clinic is an authorised health tourism intermediary registered with the Turkish Ministry of Health and HealthTürkiye. When you contact New City Clinic about the Whipple procedure, a physician first reviews your photos and medical information, and you then receive a written treatment plan with an itemised quote. Once you arrive in Istanbul, the New City Clinic team organises your airport welcome, accommodation, hospital appointments and interpreting. Your procedure is performed by a specialist physician at a Ministry of Health approved partner hospital, and follow-up continues after you return home.
Aftercare
Medication and check-ups
Take the medication your physician prescribes as directed and attend your planned check-ups.
Smoking and alcohol
Both slow healing; avoid them before and after the procedure for the period your physician advises.
Movement and rest
Short walks support circulation; wait for your physician’s approval before strenuous exercise or heavy lifting.
When to get in touch
Contact your New City Clinic coordinator straight away in case of high fever, increasing pain, redness or anything unexpected.
Frequently asked questions
Can every pancreatic tumour be operated on?
No. At diagnosis only some patients are suitable for surgery. In others, drug treatment and, where necessary, radiotherapy come first.
How long should I stay in Istanbul?
This depends on your recovery. Plan for the hospital stay and for check-ups afterwards; the expected length is stated in your written plan.
Which documents are needed for an assessment?
The CT or MRI images themselves, the pathology report if a biopsy has been taken, blood tests including CA 19-9, and a list of your medication.
Deciding on the Whipple procedure is a confident step when it is taken with the right information and the right team. You can book a free consultation with the New City Clinic team for your questions.
This article is for general information; consult your physician for diagnosis and treatment.
