Whipple procedure

Whipple Procedure (Pancreaticoduodenectomy)

A Whipple procedure — also known as a pancreaticoduodenectomy — is a complex operation to remove the head of the pancreas, the first part of the small intestine (duodenum), a part of the stomach, the gallbladder and the bile duct. After performing the Whipple procedure, remaining organs are reconnected to allow the food digestion process normally after surgery

Whipple procedure is used to treat

  • Pancreatic cancer
  • Pancreatic cysts
  • Chronic Pancreatitis
  • Ampullary cancer
  • Bile duct cancer
  • Neuroendocrine tumors
  • Duodenal cancer
  • Trauma to the pancreas or small intestine

The goal of doing a Whipple procedure for cancer is to remove the tumor and prevent it from growing and spreading to other organs. This is the only treatment that can lead to prolonged survival and cure for most of these tumors.

Surgery and post-operative recovery

Patients planned for this operation should be carefully evaluated by a specialist HPB surgeon to assess suitability. Only a few centre have the expertise to safely perform this surgery when the tumor is advanced and involves adjacent blood vessels. Then this will involve removing and reconstructing parts of blood vessels along with removing tumour.

Surgery may take six to eight hours, depending on which approach is used and the complexity of the operation. Whipple surgery is done using general anesthesia.

After surgery, need to stay in ICU for 1 or 2 days depending of the speed of recovery, following which need to stay in ward for 3 to 5 days after which can be discharged if recovered well. Initially, feeding is done through a tube placed inside the intestine through the nose during surgery. Normal oral feeding restarted by around 5 days after surgery. Post-operative complications are uncommon and primarily related to the new joints made between the pancreas and the intestine and the stomach and intestine. Most of these complications can be managed with medications and nutritional support, though occasionally surgery may be required.

After discharge, the patient will be reviewed in the outpatient clinic a couple of times for the first two weeks to ensure all is well. If the surgery is done for a cancer, then the patient may need chemotherapy depending on the stage of the tumour on the final biopsy report after multidisciplinary tumour board discussion. After completion of cancer treatment patient should be on regular follow up.

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