Pancreaticoduodenectomy (Whipple) is the surgical procedure of choice for curative resection of pancreatic head, periampullary, and distal bile duct cancers. This procedure involves removal of the pancreatic head, duodenum, distal common bile duct, and sometimes the pylorus and gastric antrum. The 2 most common complications are pancreatic fistula and delayed gastric emptying. Preoperative nutrition status has been shown to influence surgical outcomes. This technically demanding operation involves an extensive surgical resection and alters digestive processes, which can influence nutrition long term. This review article identifies the surgical and nutrition consequences associated with pancreaticoduodenectomy.