Accidental Mixed-Duct IPMN? Straight to Whipple procedure?

Hello @new2dis and welcome to Mayo Connect. You are asking good questions. As you already know, the members of Mayo Connect do not represent medical professionals, we are patients like yourself. That said, many of us have a diagnosis of IPMN, fatty liver, etc.

Before you consider a Whipple procedure, I would encourage you to get a second opinion. If you are able to consult with Mayo Clinic that would be great place to gather information and a second opinion. Here is a link with appointment information, http://mayocl.in/1mtmR63.

If, for any reason, an appointment at Mayo is not possible, I would recommend that you get a second opinion at a Pancreatic Center of Excellence. Here is the website for the National Pancreatic Cancer Foundation, https://www.npcf.us/cancer-centers/. If you contact this organization, they will probably be able to help
you find a pancreatic specialist in your area.

One of the most important things you can do now, is to get another professional opinion and some education about this issue. I look forward to hearing from you again. Will you continue to post with updates?

C) How prominent is diabetes following Whipple procedure? Being healthy and active, major post-operative issues or changes to worry about?

My non-fasting glucose was pretty high at the time of my initial PDAC diagnosis. Pancreas was obviously not functioning properly... was given some counseling, insulin, and a Dexcom.

Post-Whipple, definitely diabetic. Decent control if I exercise and watch what I eat, but can't avoid some sugar spikes w/o insulin.

PEI (Pancreatic Enzyme Insufficiency) is another outcome of having your pancreas chopped in half. You may need enzyme replacement (e.g., Creon) to digest food properly after a Whipple.

Thank you for the direction... unfortunately, I am overseas! But will definitely work towards getting a second opinion.

Many thanks for taking the time to respond and share your experience, Mark. It's exactly the type of "real life" information I am looking for (as others), but that specialists say they can't guess over (or are afraid / incentivized not to confirm). I hope you are managing it all well 🙂

are you in Europe?
I visited the Champalase Pancreas center in Lisbon. Beautiful facility and qualified, engaged doctors.
(I may not have spelled correctly, but it is on the riverfront)

I don’t know anything about IPMNs so sorry I can’t help you out with that topic, but there are several in this forum who have experience or knowledge about it.
Regarding diabetes potential: I believe it depends on how much of your pancreas is removed during the surgery. Islets of Langerhans “which produces most of the insulin are located primarily in the body and tail of pancreas. I had 70-75% of my pancreas removed during my distal surgery and I sure have a significant blood sugar problem which is probably also very prevalent because I love frozen yogurt and doughnuts, unfortunately! If you had even borderline diabetes or controlled type 2, then you may have it after. I wear a blood sugar sensor on my arm (freestyle 3), and it does help tremendously to keep track of blood sugar levels, and I take insulin before every meal. I hope you receive the guidance you need about the IPMN. Always consult with another dr for their opinion if you have doubts about your current care.

My wife had Whipple surgery December 2023 for a ductile adenocarcinoma in the head of the pancreas. Stage 2b. She has shown zero signs of diabetes - we're lucky. She does take Creon for digestion assistance. Wish you well.

Oceania... but who knows, Europe could be an option!

Thank you for taking the time to share that, Marie

Thanks vector! Glad to hear your wife is doing well on the diabatic front, and I hope surgery has not caused other issues. All the best to her too!