Woman had Extensive Whipple Procedure at Age 89
MAYWOOD, Ill. -- Loyola University Hospital cancer patient Mary Cipolla was 89 years old when she underwent one of the most extensive operations in surgery, known as the Whipple procedure.
The Whipple, used to treat pancreatic, upper intestinal and bile duct cancers, involves the removal of parts of four organs and reconstruction of the digestive tract.
On Sunday, Aug. 1, Cipolla will celebrate her 100th birthday with the same good cheer that helped her survive the surgery and beat her cancer. (She turns 100 on Friday, July 30, but her birthday party is on Sunday.)
"Mary has a very positive mind, and that has led to her long-term survival," said her surgeon, Dr. Gerard Aranha.
Cipolla lives independently with her 83-year-old sister in Roselle. She drove until she was 95 and still helps with the cooking, cleaning and shopping. She struggles with her short-term memory and needs to use a walker, but otherwise is in remarkably good health. She looks 25 years younger.
"I feel fine," she said. "I don't let the years bother me."
Cipolla was showing jaundice and weight loss when she was diagnosed with cancer in a structure near the pancreas called the ampulla of vater. The only hope for a cure was a Whipple procedure.
The Whipple procedure, also called a pancreatoduodenectomy, is named after the first American surgeon who performed the surgery. It involves removal of the head of the pancreas, the gall bladder, the duodenum (first section of the small intestine), the common bile duct and sometimes part of the stomach. The surgeon then reconstructs the digestive tract. The operation typically takes six or seven hours, and the patient spends a week or two in the hospital.
"The Whipple procedure is possibly the most demanding procedure in abdominal oncologic surgery," Aranha said.
Aranha has done about 400 Whipple procedures, and Cipolla is his oldest patient. In deciding whether to offer the surgery, he considered her physiological as well as her chronological age. She had no other major health problems and passed a heart stress test. She had lots of energy and a positive outlook, and looked no older than 60.
After coming out of surgery, she had a smile on her face and wanted to get out of bed, recalled her niece, Peg Hodgkins
During the 1970s, more than 15 percent of patients who underwent a Whipple died during the operation or shortly afterward. Improved techniques have significantly improved survival, especially at high-volume centers such as Loyola. The post-operative mortality rate of Aranha's patients is less than two percent.
At Loyola, the five-year survival rate of pancreatic cancer patients who undergo the Whipple is 20 percent. This equals the survival rate at other top hospitals, including Johns Hopkins, Sloan-Kettering and the Mayo Clinic.
"There is a feeling in this country that pancreatic cancer is a death warrant," Aranha said. "Many patients who could benefit from a Whipple are not being offered the operation. We need to change that view."
Cipolla and her family are glad that she was offered the operation.
"She has had 10 productive years with her family," Hodgkins said. "We feel very grateful to Dr. Aranha and Loyola."
Aranha is a professor in the Department of Surgery at Loyola University Chicago Stritch School of Medicine.