Whipple's Procedure and Pylorus Preserving Pancreatoduodectomy (PPPD)

Whipple’s procedure

The Whipple’s procedure (or pancreaticoduodenectomy, [‘PD’]) is the most common type of surgery to remove pancreatic tumours.  It is usually only carried out if the cancer has not spread beyond the head of the pancreas and patient is in good enough health to withstand a major operation.

What happens during a Whipple’s procedure operation?

Whipple's procedure
Diagram showing the parts to be removed during the Whipple’s surgical procedure to remove a pancreatic tumour.   Copyright Pancreatic Cancer Action 2013. All rights reserved. Do not reproduce without permission from Pancreatic Cancer Action.

The operation normally lasts for 4 to 7 hours and the surgeons will aim to completely remove the cancer to give you the best chance of cure.  The diagram (above) shows the stomach, liver, pancreas, gallbladder, small intestine and pancreas of a patient with a tumour in the head of the pancreas.  The dotted lines show the area to be resected out (cut out).

The head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum (first part of the small intestine) are removed, along with part of the stomach. The rest of the pancreas, the bile duct and the stomach are reattached to the small intestine (see diagram below).  This allows the pancreatic enzymes, bile and food to flow out into the gut, so that digestion can proceed normally.  Nearby lymph nodes may also be removed.

Diagram of organs after a Whipple's procedure
After a Whipple’s procedure.  Copyright Pancreatic Cancer Action 2013. All rights reserved. Do not reproduce without permission from Pancreatic Cancer Action.

Pylorus preserving pancreatoduodectomy (PPPD)

The Pylorus Preserving Pancreatoduodectomy (PPPD) is a modified Whipple’s procedure.  In this case, only part of the duodenum is removed and the pylorus (the part of the stomach that connects to the duodenum) is kept.  Some doctors think this helps with food digestion after the operation.

Both the Whipple’s procedure and PPPD operations are major operations with risks of complications.  You will need a general anaesthetic to keep you asleep during surgery and you’re likely to need around ten days recovering in hospital.

Before a PPPD procedure. Copyright Pancreatic Cancer Action 2013. All rights reserved. Do not reproduce without permission from Pancreatic Cancer Action.
Before a PPPD procedure
Copyright Pancreatic Cancer Action 2013. All rights reserved. Do not reproduce without permission from Pancreatic Cancer Action.

Before a PPPD procedure
Copyright Pancreatic Cancer Action 2013. All rights reserved. Do not reproduce without permission from Pancreatic Cancer Action.

After a PPPD procedure. Copyright Pancreatic Cancer Action 2013. All rights reserved. Do not reproduce without permission from Pancreatic Cancer Action.
After a PPPD procedure
Copyright Pancreatic Cancer Action 2013. All rights reserved. Do not reproduce without permission from Pancreatic Cancer Action.

After a PPPD procedure
Copyright Pancreatic Cancer Action 2013. All rights reserved. Do not reproduce without permission from Pancreatic Cancer Action.


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Information Product No. PCA0012 v1 pgs 6 - 9 | Published: 20/10/2012 | Last Updated: 17/08/2017 | Next Review Due: 20/10/2015