Medical Services • Pancreas Health

Whipple resection increases survival and offers a real chance for a cure for many pancreatic cancer patients

Dr. Malcolm Bilimoria, a surgical oncologist, heading NCH's Illinois Center for Pancreatic and Hepatobiliary Diseases, specializes in pancreatic and hepatobiliary surgeries and has performed over 600 Whipple surgical procedures in his career. The Whipple procedure is a difficult and complicated surgery. Surgeons and hospitals that do the most operations have the best results.

Tumors located in the head and neck area of the pancreas are removed with the Whipple resection; those in the body and tail are removed with distal pancreatectomy. Occasionally, a total pancreatectomy is required, though it is used less commonly.

Whipple procedures

• Whipple procedure or pancreaticoduodenectomy is the most common operation performed for pancreatic cancer and increases survival rates and offers a real chance at a cure. It is also used in the treatment of other types of cancer including small bowel cancer. Surgeons remove the head of the pancreas, parts of the stomach and small intestine, some lymph nodes, the gallbladder, and the common bile duct. The remaining organs are reconnected in a new way to allow digestion. Patients leave the hospital in an average of 14 days.
• Total pancreatectomy is performed infrequently because lifelong adverse effects may result. In this surgery, surgeons remove the entire pancreas, bile duct, gallbladder, and spleen, and possibly portions of the small intestine, stomach and nearby lymph nodes.
• Distal pancreatectomy is performed to remove tumors of the body and tail of the pancreas. The tail of the pancreas can be removed with the main portion of the organ left intact. This surgery is commonly performed for patients with chronic pancreatitis, pancreatic tumors localized in the end of the pancreas, pancreatic pseudocysts, or injury due to trauma. The spleen is usually removed during this surgery because of the close proximity of the organs. This procedure eliminates the need for surgical reconstruction.

Alternative treatments

• External beam radiation therapy – kills the cancer cells through radiation
• Chemotherapy – medications given to help shrink the tumor
• Computerized Tomographic Radiotherapy Simulator (CT-SIM) – accurately targets cancerous tumors with radiation while sparing the surrounding tissue
• Endoscopic Retrograde Cholangiopancreatography (ERCP) – a procedure done to diagnose and treat bile duct stones, and other conditions of the biliary system and pancreas. NCH has two interventional suites with digital fluoroscopy