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"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.
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