If you or someone you love has been told surgery is an option for pancreatic cancer, you want the most experienced surgical team available. At Siteman Cancer Center, WashU Medicine surgeons bring together specialists from multiple fields to plan and carry out your care, including the Whipple procedure, one of the most complex operations in not just surgical oncology but in all of surgery. At Siteman, we perform this procedure regularly, at one of the highest volumes in the nation, so you receive the care of a team that has seen and treated cases like yours many times before.
WashU Medicine surgeons have made Siteman one of the top centers in the United States for pancreatic and hepatobiliary cancer surgery. That expertise translates directly into better results for you: fewer complications, shorter hospital stays, and a care team that stays with you from your first appointment through recovery.
Our Siteman care coordinators – oncology-trained nurses who help with scheduling, finding the right specialist, and guidance – can help you through the process.
Call us directly or submit a form, and we will call you back.
What Is the Whipple Procedure?
The Whipple procedure, also called a pancreaticoduodenectomy, is the primary surgical treatment for tumors located in the head of the pancreas. It is one of the most extensive operations a surgeon can perform, and it requires a highly specialized team to do it safely.
During the surgery, your surgeon removes the head of the pancreas, the duodenum (the first part of the small intestine), the gallbladder, part of the bile duct, and the surrounding lymph nodes. In some cases, a small portion of the stomach is removed as well. Once those parts are out, the surgeon carefully reconnects your digestive system so it can continue to function.
While the Whipple surgery is complex, it is also one of the most powerful tools available to support your survivability and increase your quality of life.
The surgery generally takes five to seven hours and requires a hospital stay of about one to two weeks. Your care team will be with you every step of the way, from the moment you arrive for surgery to your last follow-up appointment.
Minimally invasive and robotic options
At Siteman, WashU Medicine surgeons offer minimally invasive Whipple procedures, including both laparoscopic and robotic-assisted approaches, in addition to the traditional open operation. Not every patient is a candidate, but when it is the right choice for you, the benefits are meaningful.
A 2021 study led by WashU Medicine researchers, published in Surgical Endoscopy, found that patients who had minimally invasive Whipple procedures experienced significantly less blood loss, lower complication rates, lower 90-day readmission rates, and were more likely to have an ideal outcome than those who had open surgery. In our surgeons’ care, patients go home an average of 3.5 days sooner after a robotic Whipple procedure.
Instead of one large incision, your surgeon makes six small openings. Most are less than an inch long, which is the key reason patients in recovery experience less pain, faster healing, and an earlier return to daily life.
- Ampullary cancer (cancer of the ampulla of Vater)
- Duodenal cancer
- Neuroendocrine tumors of the pancreas
- Chronic pancreatitis with structural complications (selected cases)
- Benign or pre-cancerous lesions of the pancreatic head (such as intraductal papillary mucinous neoplasms, or IPMNs)
Why Choose Siteman
Only the most experienced physicians can lead the Whipple procedure well. And to gain that experience a high volume of patients is critical. Studies show that patients treated at high-volume centers for the Whipple procedure have better outcomes, including lower rates of complications and shorter hospital stays.
Siteman Cancer Center is one of highest volume Whipple programs in the nation. WashU Medicine surgeons at Siteman perform 100 to 125 Whipple procedures every year. High-volume cancer centers have been proven to lead to better patient outcomes.
Siteman is the only cancer center in Missouri and the region to offer the full range of minimally invasive Whipple procedures, including both laparoscopic and robotic techniques. Over the last five years, our team has performed more minimally invasive Whipple procedures and complex pancreatic surgeries than any other center in the region, making us a destination for advanced pancreatic cancer care. We also lead in traditional open pancreatic surgery for patients who require it. With expertise across every surgical approach, your surgeon can tailor treatment to your unique anatomy and cancer. Backed by clinical outcomes comparable to the nation’s leading high-volume centers, Siteman delivers exceptional pancreatic cancer care.
Siteman is one of only four cancer centers in the United States to receive a Specialized Program in Research Excellence (SPORE) for pancreatic cancer. This National Cancer Institute (NCI) funding recognizes excellence and accelerates Siteman’s program in pancreatic cancer is driving innovation forward. This means patients looking for the most options, the best research, and the deepest experience, including surgical excellence, can find it here.
Siteman is the only NCI-designated Comprehensive Cancer Center in Missouri and the region and has held the NCI’s highest rating of “Exceptional” since 2015. That designation reflects the rigor of our research programs and the quality of care our patients receive.
A team built around you
At Siteman Cancer Center, your Whipple procedure is planned by a multidisciplinary team of WashU Medicine specialists working closely, not one doctor working alone. Your team will include surgical oncologists, medical oncologists, radiation oncologists, gastroenterologists, radiologists, and pathologists. Together they review your case as an integrated care team. They examine your medical records, imaging studies, biopsies, and genetic tests to ensure you receive an accurate diagnosis and staging before making any recommendations about treatment.
This collaboration happens through our multidisciplinary tumor board, where experts across specialties meet regularly to examine your imaging, biopsy results, and medical history. Together, they determine the most precise treatment plan for your cancer. Tumor boards significantly improve patient outcomes by bringing in specialists from different departments to determine the best options available. At Siteman, this is the standard practice that we offer every patient.
The pancreas is also one of the most active areas for clinical research at Siteman. More than 100 patients per year are enrolled in therapeutic clinical trials for pancreatic cancer. With more than 600 clinical trials available across cancer types, your care team will review whether any open trials offer you additional options. You can always ask your physician if a clinical trial is right for you.
Clinical trials are research studies that help us find new ways to prevent, diagnose, and treat cancer. If you have a rare or complex diagnosis or your treatment path seems uncertain, you might qualify for a clinical trial.
Our team will help you find a study that is right for you. Call us to speak with a Siteman care coordinator.
A Second Opinion Can Lead to Meaningful Changes
If you have been told surgery isn’t possible, or if you simply want to make sure you have explored every option, you can choose to get a second opinion at an advanced treatment center like Siteman. A second opinion at Siteman Cancer Center can help ensure you have evaluated all the very best treatment options for your cancer type. As the only NCI-designated Cancer Center in the region, you can trust Siteman to provide access to the most advanced therapies and surgical techniques available. If you are looking for a second opinion or want to refer your patient, reach out to one of our care coordinators – oncology-trained nurses who help with scheduling, navigation, and treatment options.
Your Second Opinion at Siteman
Siteman wants to be your first choice for cancer care, but that might not always be possible. If you have received a cancer diagnosis, started care somewhere else, or are a physician seeking specialized care for your patient, ask us about a second opinion. You can start the process. To make it easy, our care coordinators guide scheduling for yourself or your patient.
Frequently Asked Questions About the Whipple Procedure
Not every pancreatic or digestive cancer requires a Whipple. This procedure is typically recommended when a tumor is located in the head of the pancreas or nearby structures and has not spread to other parts of the body. Your care team at Siteman, including surgical oncologists and imaging specialists will review your scans and pathology to determine whether surgery is the right path forward. You will not be left to make this decision alone.
The Whipple procedure is complex, and it carries real risks. But surgical safety is directly linked to the experience of the surgical team and the volume of procedures they perform. At Siteman Cancer Center, our surgeons perform this operation regularly, and our track record reflects that experience.
We approach your treatment with care and minimize risks whenever possible. This is why we evaluate patients for minimally invasive surgical approaches like robotic and laparoscopic. These offer less blood loss, pain, and shorten hospital stays and recovery times.
But like any major surgery, the Whipple procedure carries risks, including infection, bleeding, and complications related to how the digestive system heals after reconstruction. The most common complication is delayed gastric emptying, which means the stomach takes longer than usual to move food through after surgery. Your care team will monitor you closely and help manage any issues that arise.
After a Whipple procedure, some patients experience changes in digestion and may need enzyme supplements or adjustments to their diet. Our team includes nutritionists and gastroenterologists who will support you through this transition.
Before your surgery, you will meet with your surgical team to review your imaging and confirm the plan. You may need additional scans, labs, or consultations with other specialists. Our care coordinators — oncology nurses who help with scheduling and navigation — will guide you from your first call and make sure every appointment is coordinated efficiently.
If you are receiving chemotherapy or radiation before surgery (called neoadjuvant therapy), your Siteman team will manage those treatments as well, so your care is seamless from start to finish.
The surgery is performed under general anesthesia and typically takes five to seven hours. Whether you have an open or minimally invasive Whipple, you will spend some time in recovery before being moved to a hospital room. Most patients stay in the hospital for one to two weeks.
Your care team will gradually reintroduce liquids and food as your body heals. Pain is managed carefully, and you will have support from nurses, dietitians, and your surgical team throughout your hospital stay.
Full recovery from a Whipple procedure takes time — typically two to three months before most patients start to return to their prior level of energy. The first weeks at home will involve rest, a careful diet, and regular follow-up appointments to make sure healing is on track.
If you had a minimally invasive Whipple, your recovery will generally be faster. Your care team will give you specific instructions for what to expect at home and who to call if any concerns arise.
Yes. Pancreatic cancer is one of the most active areas for clinical research at Siteman. Our team enrolls more than 100 pancreatic cancer patients per year in therapeutic trials at various stages of diagnosis— some testing new surgical approaches, others evaluating chemotherapy combinations, immunotherapy, or targeted agents. Your care team will review your specific diagnosis and discuss whether any trials are a good fit for you. Learn more about clinical trials.
For most patients, the Whipple procedure is covered by insurance, including Medicare and Medicaid. Our team can help you understand your specific coverage and identify financial assistance options if needed. Cost should not be a barrier to receiving this care. Our financial wellness team will review all your options and support you through the process.
If your tumor cannot be removed with surgery right now, you have options at Siteman. Some tumors that are initially considered inoperable can be treated with chemotherapy or radiation to shrink them before surgery becomes possible. This is called neoadjuvant therapy, and it is a strategy our team uses regularly.
At Siteman, your care team reviews cases like this in our multidisciplinary tumor board, and they look for every available path forward. If surgery is not the right choice, we will help you understand what is – and customize a treatment plan for you.
