Whipple Procedure
The Whipple Procedure is a complex and delicate surgery that is most often done for chronic pancreatitis or cancer of the pancreas. The pancreas is an organ that has two functions. The first is to produce insulin which controls how much sugar is in your blood. The second is to produce digestive juices that neutralize the acid that is made by your stomach. Your doctor will discuss with you how the surgery affects you.
The Whipple is also called a pancreaticoduodenectomy. During the Whipple, part of the pancreas is removed, along with a portion of both the stomach and duodenum (small intestine). The common bile duct and the gallbladder may also be removed. The stomach and pancreas are then attached to the small intestine to allow enzymes and gastric juices to pass into the digestive tract.
Day before Surgery: Bowel Prep
An important part of getting ready for surgery is cleaning your bowel. This is called a bowel prep. You need to buy 2 bottles of Magnesium Citrate (10 oz. each). You may buy this at any drugstore without a prescription. It is easier to drink chilled.
- Eat a light breakfast and lunch.
- Drink only clear liquids after lunch until midnight (there is no limit on how much you may drink).
Clear liquids:
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- At 2 pm, drink one bottle of Magnesium Citrate 10 oz.
- At 3 pm, drink the other bottle.
- You should keep drinking clear liquids only until midnight.
Remember: Nothing to eat or drink after midnight.
After Surgery
Care of the Incision
You will need to look at your incision daily. Call your doctor if you notice:
- Increased pain or tenderness at the incision
- Increased swelling or opening of the incision
- Any change in the color or amount of drainage
- Redness or warmth around the incision site
- Temperature (by mouth) above 100.5° F or 38° C
Your incision will be closed with staples or steri-strips (small tape strips).
If it is closed with steri-strips, keep them dry for 7 days. You may take a sponge bath or cover the incision with plastic wrap. After that time, you may shower and allow the strips to fall off slowly.
If it is closed with staples, you may shower as soon as you’d like. Do not rub the incision site. Just let the soapy water run over it. Do not use any lotions or creams. Keep it clean and dry.
Activities
For the first 3 weeks, avoid lifting things over 10 pounds. Keep walking and slowly resume your normal household activities. Be sure to stay within your lifting restrictions.
After 3 weeks, slowly increase your level of activity. Check with your doctor if you are not sure an activity is right for you. Listen to your body for cues. Let comfort be your guide. If it hurts, stop.
Check with your doctor about when you may:
- Resume driving. DO NOT DRIVE if you are taking narcotic pain medicine. These include Percocet®, Vicodin®, or Tylenol® #3.
- Return to work.
- Resume sexual activity.
Pain
It is normal to have some pain from the incision after you return home. Your doctor will order pain medicine for you to take home. Use these pills as you need them. They should not be taken more often than every 3 to 4 hours. A pain pill at bedtime can help you sleep well. Be sure to follow directions on the bottle. Do not drive when using narcotics.
Pain medicine can cause some problems with constipation. You can promote good bowel habits by drinking plenty of fluids and adding fiber to your diet. If constipation is a problem for you, you can use a stool softener such as Colace® or a mild laxative such as Milk of Magnesia®. You should talk this over with your doctor first.
Diet
Eat what appeals to you when you get home. Try to eat a balanced diet with protein, fruits, bread, milk, and vegetables. Do not skip meals. You should eat small, frequent meals. Include an evening snack.
You may need to test your blood sugar when you go home. This tells you if your pancreas is able to produce the insulin you need for normal living. Call your doctor if you have:
- increased thirst
- fatigue
- frequent urination
- lightheaded or dizziness
If you have questions, our dietician would be happy to go over a diet to fit your needs. Just ask your nurse to call the dietician.
You may also be given a medicine to replace the digestive enzymes that were produced by your pancreas. It is important that you take it as ordered so your body can break down the food you eat.
When to Call the Doctor
- Unusual pain in your right side
- Nausea
- Vomiting
- Severe fatigue that doesn’t go away
- Unusual drainage at the incision
- Fever of 100.5° F or 38° C
- Any unusual or prolonged bleeding
Call the Surgery Clinic at (608) 263-7502 with any questions or problems, Monday-Friday 8:00am-4:30pm.
After hours (nights, weekends, and holidays), call (608) 262-0486. Ask the paging operator for the doctor on call for Dr. ____________. They will take your name and phone number and the doctor will return your call.
If you live outside the area, call toll-free at 1-800-323-8942.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/10/2012
Copyright © 05/10/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4477
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