TP vs Whipple (Partial Pancreatectomy)

[Guest guest]

,

You wrote, " I have CP 2nd to SOD and congenital CP (my paternal grandfather

died at age 51 from pancreatic cancer). I am afraid that I will still have CP

after the Whipple because part of my pancreas will still be left. I do not

want to have a TP and become a brittle diabetic. Will having the Whipple

still give the potential of getting pancreatic cancer?

There are so many things to consider. It is good that you are staying open

and evaluating all of your options. What is hard, I know, is that at the end of

the day, the decision is your own. Some of these questions have been

addressed, already, such as the issue of developing diabetes after the TP/w/o

ICT,

which fortunately leaves that as a viable option. Remember that everyone who

has undergone the TP/ICT has not had a successful number of islet cells

harvested and some have not taken, so essentially, that has been the same as

having

the TP/w/o ICT. Even though pancreatitits induced diabetes is definitely a

challenge, there have been many new advances in insulin therapy.

The other concern having to do with the risk of CP and/or pancreatic cancer

in the remaining portion of the pancreas not removed. Both of these are

possibilities. A consideration is the genetic factor in pancreatic cancer. A

geneticist could better address the risk.

Regarding the CP, the risk of developing CP is less if the tail is free of

any calcifications and the duct in that area has not had any evidence of

stones or sludge. It would be greater, if there has been any evidence of

previous

inflammation or injury in any portion of the pancreas the doctor plans on

leaving. A review of the previous films for involvement of the tail of the

pancreas, taken during flare-ups could best evaluate the risk.

The other issue to consider is the risk of developing neuropathic pain if a

Whipple is done vs the TP. If you do not have daily pain now, then the TP

would likely assure that the spinal nerves enervating the pancreas do not

sustain

damage.

Karyn E. , RN,

Exec. Director, Pancreatitis Association International

5th Annual Symposium on Pancreatitis: September 16 & 17, 2005