The Whipple procedure, named after Dr. Alan Whipple in the 1930s, is a major surgical procedure to remove the head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum. This procedure, usually done for the treatment of various cancers, used to have a high mortality rate, but through recent advances is now a fairly safe procedure that can extend the life expectancy of the patient.
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The Whipple procedure is routinely used to treat pancreatic cancer as well as cancers involving the duodenum, the bottom end of the bile duct (called cholangiocarcinoma) and the ampulla (the area where the bile and pancreatic ducts enter the duodenum). The procedure is now safe enough to even be used for nonlife threatening conditions such as chronic pancreatitis and benign tumours of the pancreas.
About one-third of all patients who undergo the Whipple procedure will experience complications. These complications include pancreatic fistula (leakage of the pancreatic juice), paralysis of the stomach, malabsorption (the ability to digest food is changed) and weight loss. These complications can increase the patient's recovery time, but will not alter life expectancy.
Throughout the 1960s and 1970s, the mortality rate from the Whipple procedure was as high as 25 per cent. Advances in the techniques, including the use of laparoscopic procedures (the use of a thin lighted tube with a camera) and the experience of the doctors performing the procedures has greatly reduced this rate. Today, most major surgical centres boast a mortality rate of less than 5 per cent. Studies conducted from John Hopkins and Memorial Sloan Kettering conclude that the surgical outcome, including mortality and life expectancy, are greatly dependent on the experience of the hospital and surgeon.
Life Expectancy and Survival Rate
Life expectancy can be difficult to determine, especially in the case of serious conditions including cancers. Life expectancy is not only affected by the illness, including the stage, grade and characteristics, but also by age and overall health. Therefore, life expectancy is usually discussed as survival rates, which is a percentage of the number of people that live for a specified period of time after diagnosis.
Patients suffering from pancreatic cancer have a 5 per cent survival rate at five years, meaning that only 5 per cent of the patients will live five years after their diagnosis. Those patients that undergo the Whipple procedure, however, increase their survival rate to 20 per cent at five years. For those patients whose cancer has not spread to lymph nodes, they have a 40 per cent survival rate at five years. For patients with a benign (noncancerous) tumour or chronic pancreatitis, the procedure is curative, meaning they will enjoy a long natural life.
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