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Dr. Andrew Rynne

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Exp 50 years

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What is the prognosis post whipple surgery?

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Dr. Ivan R. Rommstein

General Surgeon

Practicing since :2008

Answered : 10206 Questions

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Posted on Tue, 5 Jun 2018 in Abdominal Pain
Question: My husband and I have been to the Mayo Clinic in XXXXXXX They are recommending a surgery called a whipple to remove parts of his stomach, liver and pancreas. He has some abnormal cells behind the bile duct. We understand the surgery but are concerned with his recovery. What can he expect following this surgery? He's very concerned about leading a "normal" life. We are ranchers and have a very active, physical job. Any information you can provide would help us make the decision. Thank you!
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Answered by Dr. Ivan R. Rommstein 58 minutes later
Brief Answer:
See next

Detailed Answer:
Hello and welcome to Healthcaremagic.

After reviewing his medical data, I have to say that he has really gone through several serious diseases so I believe that he is very active and physically and emotionally strong person.
Whipple procedure is complex and physiologically demanding procedure: Actually, beside liver transplant, this is one of the most complex abdominal surgeries. Consequently it is associated with certain intraoperative and postoperative risks, high morbidity rates and significant mortality rates.

On his case, there was a doubt if his common bile duct obstruction was caused by benign stricture or by malignant tumors. In case of malignant tumor, the plan is clear, it must be removed, since expected lifetime without surgery (even if chemotherapy is used) is less than 6 months,and rarely exceeds 1 year. In case of benign stricture, the treatment is completely different and Whipple should not be done. As I see, there is cytologic proof that this is adenocarcinoma which is agressive malignant tumor.
There is some minor number of false positive results in cytology, but this is rarely seen, so at this point I agree with doctors that if you want to achieve cure or at least long-term survival, then Whipple's procedure should be done.
If you want to avoid such serious surgery, then chemotherapy can be given, but as I said, you should not expect that he could survive more than 6-12 months.

Surgery carries risk of death of around 5%. It means that 1 in 20 will die immediately after surgery. ALso, complications rate is around 40%, and it means that some problems with wound, heart, lungs or infections will be seen in 40% of patients.
Furthermore, surgery may remove tumor, but recurrence of tumor is commonly seen even after successful surgery, in more than 50% of patients. SO all in all,this is very serious tumor, and even surgery cant guarantee cure and there is a long fight for him in future so I he should not think about ranch at this point, he should go step by step.

When he recovers after surgery (it takes 2-3 months) he should be able to do most daily activities as before. He may have some digestion problems, weight loss or diarrheas but if everything goes well, he should not be limited in his activities.

WIsh you good health. Feel free to ask further questions.



Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Ivan R. Rommstein 3 hours later
Thank you very much! We appreciate the input!
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Answered by Dr. Ivan R. Rommstein 9 hours later
Brief Answer:
you re welcome

Detailed Answer:
You re welcome, madam.
If you have any questions in future, before or after surgery, please feel free to contact me
Above answer was peer-reviewed by : Dr. Nagamani Ng
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