Pancreaticoduodenectomy

WHAT YOU SHOULD KNOW:

• Pancreaticoduodenectomy is also called Whipple procedure. It is done to remove a tumor (lump) from the pancreas or bile duct. A pancreatic or bile duct tumor forms when cells become cancer. The cancer cells grow and divide without control or order. These cancer cells often make too much tissue and affect other nearby structures in the abdomen (stomach). The pancreas is an organ behind the stomach which helps digest food by making digestive enzymes (chemicals). The pancreas also makes hormones, such as insulin and glucagon, which help to balance blood sugar. The pancreatic duct joins the bile duct as both ducts drain into the duodenum (upper part of small intestine).
  
  
• During the Whipple procedure, the gallbladder, duodenum, bile duct, and head of the pancreas may be removed. Sometimes, the pylorus (end part of the stomach) and lymph nodes may also be taken out. Enough of the pancreas is left to produce digestive juices and insulin. The small intestine will be attached to the stomach and to the remaining bile duct and pancreas. You and your caregiver will decide if this type of procedure for your disease is right for you. With Whipple procedure, the pancreatic or bile duct cancer may be removed, and the symptoms it causes relieved.

INSTRUCTIONS:

Medicines:

• Keep a list of your medicines: Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Take your medicine as directed: Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver.
  
  
• Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Stopping antibiotics without your caregiver's OK may make the medicine unable to kill all of the germs. Never "save" antibiotics or take leftover antibiotics that were given to you for another illness.
  
  
• Pain medicine: You may be given medicine to take at home to take away or decrease pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell caregivers if the pain medicine does not help, or if your pain comes back too soon.
  
  
• The pancreas is the organ that helps maintain normal blood sugar levels and prevent a condition called diabetes. After treatment for pancreatic cancer, you may need to use medicine to control diabetes. Ask your caregiver for more information about diabetes and how to manage it.
  
  
• If you are having chemotherapy, take your medicine exactly as you are told.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

• Your caregiver will tell you when the sutures or staples in your abdomen will be removed. Ask your caregiver how to take care of your sutures and staples at home.
  
  

Diet: It is important that you get good nutrition when you have cancer. Eat a variety of healthy foods from all the food groups. The food groups include breads, vegetables, fruits, milk and milk products, and protein (beans, eggs, poultry, meat and fish). Eating healthy foods may help you feel better and have more energy. You may need to make diet changes depending on your tolerance, the location of your cancer, or treatment side effects. For example, if you have trouble swallowing, try eating foods that are soft or in liquid form. Ask your caregiver if you should add special drinks or vitamins to your diet. Tell your caregiver if you are nauseated, vomiting, or have other problems eating or digesting your food.

Rest: You may feel like resting more after surgery. Slowly start to do more each day. Rest when you feel it is needed.

Wound care:

• After the procedure, a thin stent (tube) may be placed in your wound to drain fluid. This drain may be connected to a suction container to collect the fluid. Your bandage may need to be changed more often if the drain is not connected to a container.
  
  
• When you are allowed to bathe or shower, carefully wash the incision with soap and water. Afterwards, put on clean, new bandages. Change your bandage any time it gets wet or dirty. Ask your caregivers for more information about wound care.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You have chills, a cough, or feel weak and achy.
  
  
• You have dizziness, nausea (upset stomach), or vomiting (throwing up).
  
  
• Your bandage becomes soaked with blood.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your procedure, condition, or care.

SEEK CARE IMMEDIATELY IF:

• You have pus or a foul-smelling odor coming from your incision.
  
  
• You have severe abdominal pain that does not go away even after taking pain medicines.
  
  
• You have more jaundice (yellowing of your skin and whites of the eyes) than before.
  
  
• You have trouble breathing, seeing, talking, or thinking clearly.
  
  
• You passed out or had a seizure (convulsion).
  
  
• Your face or other parts of your body are getting numb or you cannot move your arms or legs.
  
  
• Your symptoms come back or become worse.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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