Whipple procedure (pancreaticoduodenectomy)
The Whipple procedure (also called a pancreaticoduodenectomy) is the primary surgical treatment for pancreatic cancer that occurs within the head of the gland. During this procedure, surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct, the gallbladder and associated lymph nodes. The classic Whipple procedure is named after Allen Whipple, MD, a Columbia University surgeon who was the first American to perform the operation in Also known as pancreaticoduodenectomy, .
Named after an American surgeon, Allen O. Whipple is a surgery called Whipple Procedure also called Pancreaticoduodenectomy. A Whipple procedure is a surgical operation done primarily for Pancreatic Cancer patients. The procedure is usually done so as to remove an enlargement on the duodenum. It can be the removal of bile duct or head of the pancreas. It can also be done for patients with chronic pancreatitis or for those patients who have bile duct or pancreatic duct strictures.
The physician will explain and illustrate a drawing of the sections of the body involved for the patient to see. The whole procedure is usually completed in four to six hours. The patient may possibly procdure a blood transfusion at some stage in the procedure. The surgery can include detaching one or more of whipole following:. Pancreatic fistula can be a complication of Whipple procedure. This happens if there are problems during the healing process of the suture that how to flash htc hd7 rom what remains of the pancreas to the intestine.
Subsequently, leakage of the pancreatic juice can occur. In most cases, the leakage will repair on its own without requiring another surgery.
However, in rare cases, another operation might be needed to repair the leak. Furthermore, 25 out of patients can have stomach paralysis after the procedure. However, one normally recovers in four to six weeks time. In cases of stomach paralysis, the patient whipplr required to temporarily obtain nutrition proceduge a feeding tube.
The usual long term side effects of a Whipple procedure are problems with digestion, such as: Diabetes Malabsorption Pancreqs loss. Diabetes After the surgery, diabetes may manifest in the wgipple who has undergone the surgery.
Diabetes is a metabolic problem wherein the body does not produce insulin or lacks insulin to control blood glucose. This can happen in Whipple procedure patients because insulin production will be reduced once a part of the pancreas is removed. This will also be a big problem if the patient already has diabetes before the surgery, for it may worsen their condition. Malabsorption Malabsorption how to get the screen shot also take place after the surgery.
In malabsorption, the patient often has issues absorbing nutrients because when a part of the pancreas is removed it also reduces the number of pancreatic enzymes that it produces.
These pancreatic enzymes are essential for good digestion and absorption. Weight loss Patients who have this problem is often caused by frequent diarrhea with oily and bulky stools. Pancreatic enzyme supplements taken orally can provide a relief when taken on a long-term basis. The reason for the weight loss is patients have a limited proedure after the procedure. The good news is their normal weight will return once they are allowed to eat normally again. Pancreatic cancer rarely happens, but once there is a diagnosis, it will be a struggle to fight it.
Only 5 out of diagnosed with pancreatic cancer live after five years with it, compared to provedure out of colon cancer patients and 90 out of female breast cancer patients.
It is the most frequently used treatment for this disease. During the s, 15 out of of the patients died while undergoing wipple Whipple procedure or soon after the procedure. However, new developments in anesthesia, surgical practice, and care after surgery have greatly reduced the fatality rate during and after the procedure. There is a correlation between iis rate and experience of both hospitals and surgeons.
They have found out that hospitals that perform fewer Whipple operations may have a significantly higher fatality rate.
Pancreatoduodenectomy (the Whipple Procedure)
Dec 18, · The Whipple procedure, or pancreaticoduodenectomy, is the most common surgery to remove tumors in the pancreas. Surgery to remove a tumor offers the best chance for long-term control of all pancreatic cancer types. The Whipple removes and reconstructs a large part of the gastrointestinal tract and is a difficult and complex operation. Mar 15, · The Whipple procedure is a surgery that removes the head of the pancreas, the distal bile duct, the gallbladder, regional lymph nodes, and the duodenum — the first part of the small intestine that connects to the stomach. For some patients, it may also include partial removal of the stomach, as well as nearby veins and/or arteries. Named after a surgeon who worked at MSK in the s, the Whipple Procedure (also known as pancreatoduodenectomy) is used to remove cysts in the head of the datingfuckdating.com this approach, surgeons remove not only the head of the pancreas but also part of the small intestine, the lower half of the bile duct, the surrounding lymph nodes, the gallbladder, and sometimes part of the stomach.
But it can be hard to stage pancreatic cancer accurately just using imaging tests. Sometimes laparoscopy is done first to help determine the extent of the cancer and if it can be resected. For this procedure, the surgeon makes a few small incisions cuts in the abdomen belly and inserts long, thin instruments.
One of these has a small video camera on the end so the surgeon can see inside the abdomen and look at the pancreas and other organs. Biopsy samples of tumors and other abnormal areas can show how far the cancer has spread. This is a very complex surgery and it can be very hard for patients.
It can cause complications and might take weeks or months to recover from fully. Fewer than 1 in 5 pancreatic cancers appear to be confined to the pancreas at the time they are found. Even then, not all of these cancers turn out to be truly resectable able to be completely removed. Sometimes after the surgeon starts the operation it becomes clear that the cancer has grown too far to be completely taken out. This is because the planned operation would be very unlikely to cure the cancer and could still lead to major side effects.
It would also lengthen the recovery time, which could delay other treatments. Even if all visible cancer is removed, often some cancer cells have already spread to other parts of the body.
These cells can grow into new tumors over time, which can be hard to treat. Curative surgery is done mainly to treat cancers in the head of the pancreas. Because these cancers are near the bile duct, they often cause jaundice, which sometimes allows them to be found early enough to be removed completely.
During this operation, the surgeon removes the head of the pancreas and sometimes the body of the pancreas as well. Nearby structures such as part of the small intestine, part of the bile duct, the gallbladder, lymph nodes near the pancreas, and sometimes part of the stomach are also removed.
The remaining bile duct and pancreas are then attached to the small intestine so that bile and digestive enzymes can still go into the small intestine.
The end pieces of the small intestine or the stomach and small intestine are then reattached so that food can pass through the digestive tract gut. Most often, this operation is done through a large incision cut down the middle of the belly. A Whipple procedure is a very complex operation that requires a surgeon with a lot of skill and experience. It carries a relatively high risk of complications that can be life threatening.
In general, people having this type of surgery do better when it's done at a hospital that does at least 15 to 20 Whipple procedures per year. Still, even under the best circumstances, many patients have complications from the surgery. These can include:. In this operation, the surgeon removes only the tail of the pancreas or the tail and a portion of the body of the pancreas. The spleen is usually removed as well. To help with this, doctors recommend that patients get certain vaccines before this surgery.
This surgery is used to treat cancers found in the tail and body of the pancreas. Unfortunately, many of these tumors have usually already spread by the time they are found and surgery is not always an option. This operation removes the entire pancreas, as well as the gallbladder, part of the stomach and small intestine, and the spleen. This surgery might be an option if the cancer has spread throughout the pancreas but can still be removed. But when the entire pancreas is removed, people are left without the cells that make insulin and other hormones that help maintain safe blood sugar levels.
These people develop diabetes, which can be hard to manage because they are totally dependent on insulin shots. People who have had this surgery also need to take pancreatic enzyme pills to help them digest certain foods.
Before you have this operation, your doctor will recommend that you get certain vaccines because the spleen will be removed. If the cancer has spread too far to be removed completely, any surgery being considered would be palliative intended to relieve symptoms.
Sometimes surgery might be started with the hope it will cure the patient, but once it begins the surgeon discovers this is not possible. In this case, the surgeon might do a less extensive, palliative operation known as bypass surgery to help relieve symptoms.
Cancers growing in the head of the pancreas can block the common bile duct as it passes through this part of the pancreas. The bile chemicals will also build up in the body, which can cause jaundice, nausea, vomiting, and other problems.
There are two main options to relieve bile duct blockage in this situation:. The most common approach to relieving a blocked bile duct does not involve actual surgery. Instead, a stent small tube, usually made of metal is put inside the duct to keep it open. This is usually done through an endoscope a long, flexible tube while you are sedated. Often this is part of an endoscopic retrograde cholangiopancreatography ERCP.
The doctor passes the endoscope down the throat and all the way into the small intestine. Through the endoscope, the doctor can then put the stent into the bile duct. The stent can also be put in place through the skin during a percutaneous transhepatic cholangiography PTC. See Tests for Pancreatic Cancer. The stent helps keep the bile duct open even if the surrounding cancer presses on it.
But after several months, the stent may become clogged and may need to be cleared or replaced. Larger stents can also be used to keep parts of the small intestine open if they are in danger of being blocked by the cancer.
A bile duct stent can also be put in to help relieve jaundice before curative surgery is done which would typically be a couple of weeks later. This can help lower the risk of complications from surgery.
In people who are healthy enough, another option for relieving a blocked bile duct is surgery to reroute the flow of bile from the common bile duct directly into the small intestine, bypassing the pancreas.
This typically requires a large incision cut in the abdomen, and it can take weeks to recover from this. Sometimes surgery can be done through several small cuts in the abdomen using special long surgical tools. This is known as laparoscopic or keyhole surgery. Having a stent placed is often easier and the recovery is much shorter, which is why this is done more often than bypass surgery. But surgery can have some advantages, such as:. Sometimes, the end of the stomach is disconnected from the duodenum the first part of the small intestine and attached farther down the small intestine during this surgery as well.
This is known as a gastric bypass. This is done because over time the cancer might grow large enough to block the duodenum, which can cause pain and vomiting and often requires urgent surgery.
Bypassing the duodenum before this happens can sometimes help avoid this. For more about surgery as a treatment for cancer, see Cancer Surgery.