Specialty Procedures:
Surgical Procedures for Pancreatic Cancer

The Whipple or pancreaticoduodenectomy procedure involves partial removal of the stomach, complete removal of the gallbladder, a portion of the bile duct, head of the pancreas, portions of the small intestine, and regional lymph nodes. Because of concerns that the standard Whipple might be associated with nutritional problems later on, many surgeons, and most of those at the Brigham and Women's Hospital, have modified the Whipple to preserve the stomach and keep digestion as near normal as possible.

In cases where the pancreatic cancer or tumor is not in the "head" but in the "body" or "tail" of the pancreas, then surgery involves removing the back half of the pancreas, usually with the spleen. This procedure is called distal pancreatectomy and splenectomy.

In some patients who are not candidates to have the tumor removed, surgery helps to bypass the blockage created by the tumor to palliate or alleviate symptoms of jaundice or intestinal blockage.

Whipple procedures and distal pancreatectomies are highly complex operations that require both individual surgeon and institutional team approaches to keep the risks of this operation to a minimum. Prior to 1980, it was common for mortality rates from these operations to be as high as 20-25%. Since that time, national mortality rates have decreased to be in the range of 5%. The Brigham and Women's Hospital mortality rate for the last 300 patients undergoing pancreatic resections was 2.3%. This is accomplished by dedicating highly trained individuals to this area.

It is common for patients with pancreatic cancer to also receive radiation and chemotherapy. This is done in collaboration with our medical oncologists and radiation therapists at the Dana-Farber Cancer Institute and the Dana-Farber Gastrointestinal Cancer Center.