My husband just has pancreatic cancer and he just underwent a whipple procedure. Is there a special diet that he should follow after surgery?

A Whipple procedure involves the removal of part of the pancreas, bile duct, gallbladder, and duodenum (first portion of the small intestine). Sometimes part of the stomach is removed as well. This procedure is generally used to remove areas of cancer, but can also be used when chronic pancreatitis has been an issue.

The surgeon generally places a feeding tube during the time of surgery to provide nutrition to aid in the healing process. After surgery the patient is generally not allowed to eat and the tube feeding is slowly advanced to a goal rate. When the doctor feels it is appropriate, a diet will be initiated. Generally clear liquids are started (jello, broth, juice) and then advanced to a full liquid diet (yogurt, pudding, cream of wheat, smoothie) and then eventually to a general diet as tolerated. The physician may then have the tube feeding weaned down and switched to a cyclic regimen (where the patient would run the tube feeding at night to allow him to eat during the day).

I recommend that patients follow a modified diet after this procedure. I first suggest that they eat six small meals instead of three larger meals. Generally people tell me that they fill up fast so six small meals are easier for people to take. Now I have patient’s focus on getting enough protein so including a protein filled food at most of the small meals is important. This could include: eggs, lean meats, low fat dairy products, peanut butter, soy products, nuts, beans and nutrition supplement drinks.

It is important that you are monitoring your husband for any side effects from the surgery that may make eating difficult. For example, if he is struggling with diarrhea, I recommend limiting insoluble fiberous foods (raw/dried fruits and veggies with the skin, bran, popcorn, nuts, seeds), greasy/fatty/fried foods, caffeine, and limiting dairy products. Sometimes limiting intake of foods that are very spicy or acidic can help as well. If your husband is experiencing nausea, make sure you are offering bland/dry foods and try to limit foods with a strong odor or those that are greasy/fatty/or fried. Your doctor may have you begin checking your husband’s blood sugar levels. If they are high, limit his intake of concentrated sweets (cookies, candy, pie, cake, sugary drinks) and make sure adequate fiber and protein are being consumed. Your surgeon may also prescribe pancreatic enzymes. These should be taken when meals are consumed and will simply help his body digest the food more easily.

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