Definition of pancreatoduodenectomy (whipple procedure)
The Whipple procedure (pancreatoduodenectomy) is the most common operation to remove pancreatic cancers. The Whipple procedure may also be used to treat some benign pancreatic lesions and cysts and cancers in the bile duct and beginning part of the small intestine (duodenum).
The goal of the Whipple procedure (pancreatoduodenectomy) is to remove the head of the pancreas, where most tumors occur. Because the pancreas is so integrated with other organs, the surgeon must also remove the first part of small intestine (duodenum), the gallbladder, the end of the common bile duct and sometimes a portion of the stomach. In the reconstruction phase of the operation, the intestine, bile duct and remaining portion of the pancreas are reconnected.
The Whipple procedure is a difficult and demanding operation for both the person undergoing surgery and the surgeon.
A laparoscopic Whipple procedure may be offered to select individuals. The laparoscopic Whipple procedure is performed through six small incisions in the abdominal wall. A laparoscope, a long thin tube with a lighted camera at its tip, is inserted through one incision. The surgeon operates using specially designed surgical instruments placed through the remaining incisions, guided by the laparoscope images shown on a monitor in the operating room.
Laparoscopic Whipple surgery usually takes four to five hours. Most people leave the hospital in four to six days, compared with eight to 10 days for those who have conventional surgery. One month after a laparoscopic Whipple procedure, most people are able to eat normally, and many can return to work and normal activities.
The most common post-surgical complication of pancreatoduodenectomy is leaking of pancreatic juices from the incision. If this occurs, a drain may be inserted through the skin to allow drainage for several weeks after surgery. Weight loss is another frequent complication of the Whipple procedure. Diabetes is a potentially serious concern for some people (a minority) after surgery. In general, although many people do very well after the Whipple procedure, some develop immediate complications that affect their quality of life.