Whipple Surgery on the Pancreas

Whipple surgery is an operation involving the removal of the head of the pancreas, the first part of the small intestine (duodenum), part of the bile duct, the gallbladder, and sometimes part of the stomach. Generally, this operation is used to treat pancreatic cancer.

The pancreas is part of the human digestive system. This organ is behind the abdominal cavity, functioning to produce hormones and enzymes to destroy food. Anatomically, the pancreas is divided into 3 parts, namely the head, body, and tail.

One of the most dangerous diseases of the pancreas is pancreatic cancer. Because, pancreatic cancer can grow and spread to other organs without causing any symptoms making it difficult to detect.

In addition, of all existing types of cancer, pancreatic cancer has the least life expectancy. Only about 6% of pancreatic cancer patients are able to survive up to 5 years after being diagnosed with the condition.

In some patients with pancreatic disease (including pancreatic cancer that has not spread), Whipple surgery can prolong lifespan and potentially cure. Patients who successfully undergo Whipple surgery have a life expectancy of 5 years to 25%.

Conditions Handled with Whipple Surgery

In addition to treating pancreatic cancer that has not spread, Whipple surgery can also be used to treat some of the following diseases:

  • Pancreatic cysts, a condition when fluid-filled sacs form in the pancreas
  • Intraductal papillary mucinous neoplasm (IPMN), a specific type of tumor that can grow on the head of the pancreas and potentially become cancerous
  • Pancreatic tumors, which are conditions when tumors grow in the pancreas, include some types of benign tumors
  • Chronic pancreatic inflammation, i.e. inflammation of the pancreas that damages and permanently stops pancreatic function
  • Vater ampula cancer, a cancer that grows in the meeting area between the bile ducts and the pancreas
  • Bile duct cancer, i.e. cancer that grows in the bile ducts
  • Neuroendocrine tumors, i.e. tumors that form in hormone-producing (endocrine) cells as well as in nerve cells
  • Duodenal cancer, a cancer that grows in the early part of the small intestine

Whipple Surgery Procedure

When the operation will begin, the patient will be completely sedated so as not to feel pain during the procedure.

In the process of surgery, the doctor will remove the head of the pancreas, most of the duodenum (the first part of the small intestine), as well as part of the gallbladder, gallbladder, and adjacent lymph nodes. In some cases, part of the stomach is also removed.

After that, the process is continued with reconstructive surgery to reconnect the remaining digestive organs. The entire procedure usually takes about 7 hours.

Whipple surgery can be performed in three ways: open surgery, laparoscopic surgery, and robotic surgery. Here’s an explanation:

Open operation

In open surgery, the doctor will make a wide incision in the abdomen to access the pancreas. This surgery technique is the fastest and most common performed in Whipple surgery.

Laparoscopic surgery

At laparoscopic surgery, the doctor will make some small incisions in the abdomen. The incision became the entry line of surgical equipment, including the camera used to guide the doctor in performing whipple surgery.

Robotic surgery

In robotic surgery, surgical tools are paired in a mechanical device (robot) that is then controlled by a doctor. Robotic surgery allows doctors to reach a narrow area of the organ.

Laparoscopic and robotic surgery offers several advantages, namely a lower risk of bleeding and faster recovery after surgery. The downside is that the operation takes longer than an open operation, and if there is a problem during the operation, an open operation is required to complete the operation.

Complications of Whipple Surgery

Whipple surgery is a major operation that can cause a variety of complications, including:

  • Diarrhea
  • Weight loss due to malnutrition
  • Diabetes
  • Impaired gastric function
  • Leakage of intestinal or bile duct connections
  • Fistula
  • Infection
  • Bleeding

Treatment After Whipple Surgery

After whipple surgery, patients can be treated in a regular inpatient room or intensive care unit (ICU).

Regular inpatient room

Most patients will be treated immediately in the general surgical care ward after surgery. The length of the hospitalization depends on the patient’s condition, but generally about 1 week. During the hospitalization, the doctor will monitor the patient’s progress several times a day and observe signs of infection or other complications.

Patients will also be advised to undergo a special diet, and the diet will be loosened slowly. Generally, patients can walk immediately after surgery.

Intensive care unit (ICU)

If the patient has a specific medical condition, the doctor may advise the patient to be treated in the ICU after surgery. The doctor will monitor the patient’s condition constantly to observe signs of complications.

Patients will be given fluids, nutrients, and medicines through infusions. In addition, patients can also be fitted with special hoses to remove urine or fluids that settle in the operating area.

Most patients can return to normal activities within 4–6 weeks after surgery. The length of time the patient recovers depends heavily on his physical condition before the operation and the complexity of the operation. If any complaints arise upon returning home, consult a doctor immediately.

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