{"entity":{"id":"paper-whipple-carcinoma-ampulla-of-vater-ann-surg-1935","kind":"paper","name":"Treatment of carcinoma of the ampulla of Vater","aka":[],"tldr":"The 1935 report in which Allen Whipple and two colleagues described removing the head of the pancreas and the duodenum for cancer at the junction of the bile duct and bowel, the operation that still carries his name and remains the only route to cure.","summary":"Whipple, Parsons and Mullins, Annals of Surgery, October 1935, pages 763 to 779. Europe PMC indexes no abstract for this article, so OnCo carries no figures from it; the paper is the origin of the two-stage, then one-stage, pancreaticoduodenectomy. Nine decades later the operation, refined by Traverso and Longmire's pylorus-preserving variant (1978) and by centralisation into high-volume centres, is still the only treatment that cures pancreatic cancer, and about one patient in five presents with disease that can be removed.","asOf":"2026-09-24","links":[{"label":"Ann Surg 1935","url":"https://doi.org/10.1097/00000658-193510000-00023"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/17856666/"},{"label":"Europe PMC full text (PMC1391173)","url":"https://europepmc.org/article/MED/17856666"}],"tags":["pancreatic-evidence"],"related":["surgery-roadmap","paper-traverso-longmire-pylorus-preservation-pancreaticoduodenectomy-sgo-1978"],"cancers":["pancreatic","resectable-pdac"],"sections":["surgery"],"technologies":["robotic-surgery"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["whipple","resectability"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"journal":"Annals of Surgery","year":1935,"doi":"10.1097/00000658-193510000-00023","pmid":"17856666","authors":"Whipple AO, Parsons WB, Mullins CR.","paperType":"observational","findings":["No abstract is indexed on Europe PMC; the paper describes the operation and the first patients."],"whatItMeans":"Every treatment on this roadmap is either a way to reach this operation, a way to make it work better, or a substitute for patients who cannot have it.","caveats":["A case series from the 1930s, before antibiotics, blood banking and modern anaesthesia; operative mortality was high for decades.","The paper concerns ampullary cancer; the operation was extended to cancers of the pancreatic head."],"changedPractice":true},"route":"/key-papers/paper-whipple-carcinoma-ampulla-of-vater-ann-surg-1935/","neighbours":{"roadmap":[{"id":"pancreatic-roadmap","kind":"roadmap","name":"Pancreatic cancer roadmap: from Whipple's operation to gemcitabine, FOLFIRINOX, adjuvant chemotherapy, PARP inhibition, KRAS inhibition, vaccines and the surveillance question","route":"/roadmaps/pancreatic-roadmap/"},{"id":"surgery-roadmap","kind":"roadmap","name":"Surgery roadmap: radical operations → less surgery → no surgery when a drug has done the work","route":"/roadmaps/surgery-roadmap/"}],"paper":[{"id":"paper-traverso-longmire-pylorus-preservation-pancreaticoduodenectomy-sgo-1978","kind":"paper","name":"Preservation of the pylorus in pancreaticoduodenectomy","route":"/key-papers/paper-traverso-longmire-pylorus-preservation-pancreaticoduodenectomy-sgo-1978/"}],"cancer":[{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"},{"id":"resectable-pdac","kind":"cancer","name":"Resectable pancreatic ductal adenocarcinoma","route":"/cancers/resectable-pdac/"}],"section":[{"id":"surgery","kind":"section","name":"Surgery & Interventional","route":"/fronts/surgery/"}],"technology":[{"id":"robotic-surgery","kind":"technology","name":"Robotic & minimally invasive surgery","route":"/technologies/robotic-surgery/"}],"term":[{"id":"resectability","kind":"term","name":"Resectable, borderline resectable and unresectable","route":"/terms/resectability/"},{"id":"whipple","kind":"term","name":"Whipple procedure (pancreaticoduodenectomy)","route":"/terms/whipple/"}]}}