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complications."},"complication_rate_pct":{"min":40,"max":60,"unit":"percent","qualifier":"Any complication within 90 days after pancreatoduodenectomy; clinically relevant pancreatic fistula about 10-20%, mortality 1-3%."},"contraindications":["Distant metastatic disease (stage IV)","Unresectable locally advanced tumor with arterial encasement (SMA, celiac)","Unfit for major surgery (severe cardiopulmonary disease, poor status)","Uncontrolled sepsis or untreated biliary infection (relative; treat first)","Severe malnutrition not optimized (relative)"],"days_in_clinic":{"min":7,"max":14,"unit":"nights","qualifier":"Typical for open or minimally invasive pancreatoduodenectomy in uncomplicated course; complications prolong stay."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"Walking earlier; heavy lifting and strenuous exercise after wound healing and surgeon clearance."},"final_result_months":{"min":3,"max":6,"unit":"months","qualifier":"Time to full functional recovery and stable digestion and weight; longer with complications or adjuvant chemotherapy."},"fly_home_after_days":{"min":10,"max":21,"unit":"days","qualifier":"After discharge with drains removed and eating well; depends on surgeon clearance, complications and thrombosis risk."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"Early postoperative check after discharge, including drain/wound review."}},{"purpose":"result_review","requirement":"routine","after":{"min":14,"max":42,"unit":"days","qualifier":"Pathology review and planning of adjuvant therapy."}},{"purpose":"assessment","requirement":"routine","after":{"min":84,"max":120,"unit":"days","qualifier":"Oncologic surveillance with clinical review, tumor markers and imaging."}}],"indications":["Resectable or borderline 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instructions","Smoking and alcohol cessation","Discussion of medication management with the care team"],"recovery_timeline":[{"phase":"Hospital stay (days 0-14)","description":"Pain control, gradual return to oral diet, drain management, mobilization and monitoring for fistula, bleeding or infection.","restrictions":["Early walking encouraged","Dietary progression under supervision"]},{"phase":"Early home recovery (weeks 2-6)","description":"Gradual increase in activity and appetite; pancreatic enzyme and glucose monitoring as needed; pathology review and adjuvant therapy planning.","restrictions":["No heavy lifting","Avoid driving while on opioids"]},{"phase":"Late recovery (weeks 6-12)","description":"Return to work and normal activity unless adjuvant chemotherapy is ongoing; weight and nutrition follow-up.","restrictions":["Gradual resumption of strenuous exercise after surgeon clearance"]}],"rehabilitation_days":{"min":42,"max":90,"unit":"days","qualifier":"Ordinary functional 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Recurrence is common, so long-term outcome depends on pathology and adjuvant therapy; enzyme replacement or diabetes management may be lifelong.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Unplanned reoperation or reintervention within 90 days, mainly for bleeding, leak or abscess."},"scars":"Open surgery leaves a midline or subcostal upper abdominal scar; laparoscopic or robotic approaches leave several small scars.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation (pancreatoduodenectomy); adjuvant or neoadjuvant therapy is separate."},"stages":[{"code":"resection_reconstruction","label":"Tumor resection with digestive reconstruction in one operation","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of surgery."}}],"qualifier":"Describes the standard pancreatoduodenectomy for a pancreatic head tumor, performed in one operation."},"success":{"metric":"Median overall survival after resection plus adjuvant chemotherapy","value":28,"unit":"months","horizon":"Median, from surgery","population":"Adults with resectable pancreatic ductal adenocarcinoma without metastases, receiving adjuvant chemotherapy","evidence_status":"limited"},"techniques":[{"name":"Pancreatoduodenectomy (Whipple or pylorus-preserving)","suits_whom":"Tumors of the pancreatic head or uncinate process.","recovery":"Hospital stay about 1-2 weeks; return to normal activity over about 6-12 weeks."},{"name":"Distal pancreatectomy (usually with splenectomy)","suits_whom":"Tumors of the pancreatic body or tail.","recovery":"Often somewhat shorter hospital stay; recovery over weeks."},{"name":"Total pancreatectomy","suits_whom":"Extensive or multifocal tumors, or when a safe anastomosis is not possible.","recovery":"Longer recovery; lifelong insulin and enzyme replacement required."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":4,"max":8,"unit":"hours","qualifier":"Typical operating time for standard pancreatoduodenectomy; vascular resection or total pancreatectomy may take longer."},"initial_assessment_documents":["Contrast-enhanced pancreatic protocol CT scan","Abdominal MRI or MRCP","Biopsy or cytology report","CA 19-9 and other tumor marker results","Endoscopic ultrasound report (if available)","Recent blood tests including liver function"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single operation; stay 2-3 weeks including hospital recovery. 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been given full information regarding the benefits and risks of the proposed operation, plus possible alternatives.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Check how your individual risks are assessed, since risks differ for each patient","scope":"procedure","source":{"url":"https://www.plymouthhospitals.nhs.uk/display-pil/pil-whipple-operation-information-for-you-and-your-family-5958&rut=be533a60458e04a5855e2f547d78a32fd9203d86bc86eb560ac1f81ef4c7d3ae","host":"plymouthhospitals.nhs.uk","quote":"Major surgery such as this places a strain on the body’s resources; the risks for any individual patient are different and are assessed person by person.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Check a specialist team will monitor you for complications after 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38’C","urgency":"contact_clinic","general":true,"source":{"url":"https://www.leedsth.nhs.uk/services/pancreas-unit/what-is-the-pancreas/pancreas-surgery/","host":"leedsth.nhs.uk","quote":"– A fever (temperature above 38’C) Redness or leakage from the wound Nausea / vomiting Jaundice (yellowing of the skin) Any new or unexplained symptoms","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Shows injections the home doctor must continue for 28 days","document":"medicines list","source":{"url":"https://www.plymouthhospitals.nhs.uk/display-pil/pil-whipple-operation-information-for-you-and-your-family-5958&rut=be533a60458e04a5855e2f547d78a32fd9203d86bc86eb560ac1f81ef4c7d3ae","host":"plymouthhospitals.nhs.uk","quote":"These injections are called Clexane and will need to continue for 28 days 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