Whipple Surgery Procedure in Pancreatic Cancer Treatment

The Whipple procedure, also known as pancreaticoduodenectomy, is a complicated surgical procedure involving the removal of a segment of the pancreas, a portion of the small intestine, the gallbladder, a segment of the bile duct, and associated lymph nodes. This procedure is typically used to treat pancreatic cancer in aggressive stages and conditions that affect the pancreas, gallbladder, small intestine, and bile duct.

It is worth noting that the Whipple procedure lasts approximately six hours, and patients undergoing this surgery are usually hospitalized for around two weeks for close monitoring and care.

What is the Whipple Procedure?

When pancreatic cancer spreads to nearby structures and affects the small intestine, gallbladder, and bile duct, the surgeon performs a Whipple procedure to remove the affected areas. This may involve removing the head of the pancreas, the upper part of the small intestine or duodenum, the gallbladder, the bile duct, and lymph nodes.

Whipple procedure is complex and may have many complications, but it has been proven to save the lives of patients with pancreatic cancer.

Where is the Pancreas, and what does it do?

The pancreas is a vital structure that is located behind the stomach. It is a 25cm long organ thick from one side and slim at the other. The pancreas has two most essential functions in the body: it helps digest food and regulate blood sugar levels through its hormones.

The pancreas releases enzymes like trypsin, lipase, and amylase to digest the protein, fats, and carbohydrates, respectively. These enzymes only become active during the digestion. On the other hand, the pancreas releases hormones like insulin and glucagon that help in controlling the level of sugar in the blood.

When is a Whipple procedure done?

Whipple procedure is performed in 15% to 20% of patients who have pancreatic cancer. However, the procedure can also be performed in other conditions that affect the pancreas and the structures in the surrounding area. These may include:

Pancreatic cancer
Ampullary cancer
Distal bile duct cancer
Duodenal cancer
Chronic pancreatitis with complications
Pancreatic cysts or tumors
Neuroendocrine tumors of the pancreas

What are the steps of the Whipple procedure?

Whipple's procedure steps are described as follows:

Incision under Anesthesia: A large incision is given in the abdominal area under the effect of anesthesia. But, in the case of minimally invasive procedures, small incisions are given.
Removal of tumor and associated structures: Pancreatic tumor is removed surgically alongside the upper portion of the small intestine, bile duct, gallbladder, and lymph nodes.
Joining of the remaining parts: After the removal of the tumor, the remaining portion of the pancreas is then attached to the remaining portion of the small intestine and bile duct.
Attaching the small intestine to the stomach: To restore the digestive process, the surgeons make sure to attach the small intestine to the stomach.
Sutures: After the restoration of the digestive tract, the surgeon closes the incision with the help of sutures and applies medications to prevent complications.

How long does the Whipple procedure last?

Whipple procedure is a complicated procedure in which many organs are involved, so it may take 6 to 12 hours to complete with great accuracy.

What are the advantages of the Whipple procedure?

Whipple procedure helps resolve pancreatic cancer, but it has some of the following advantages:

Whipple Surgery removes cancerous or precancerous tumors from the pancreas, bile duct, or duodenum.
This treatment can be used to treat early-stage pancreatic cancer and other cancers like ampullary cancer.
It also helps alleviate symptoms such as jaundice, pain, and digestive issues, improving the quality of life by resolving problems like obstruction or blockages in the bile duct or pancreatic duct.
This surgery can increase survival rates for patients with certain types of pancreatic and periampullary cancers and allows for more accurate staging and assessment of the cancer.
Additionally, it can be combined with other treatments like chemotherapy and radiation for comprehensive care.

What are the Complications and Side Effects of the Whipple procedure?

Because of the complicated nature of the Whipple procedure and the involvement of various organs in a single surgery, the Whipple procedure has risks and may have the following complications:

Infection
Bleeding
Pancreatic fistula
Delayed gastric emptying
Malabsorption
Diabetes
Nutritional deficiencies
Anastomotic leak
Bile leak
Organ dysfunction or failure

Improving the chance of success

To improve the chances of success of Whipple Surgery, you can follow some strategies that are mentioned below:
Always choose a surgeon with great skills and experience, having performed Whipple surgery for many years.
Choose a hospital with advanced technology, quality services, and high success rates of treatments.
Make an informed decision after learning about the procedure, its complications, and its outcomes.
Follow the guidelines of your surgeon and take medications according to prescription.
Follow a healthy lifestyle after the procedure to minimize the chances of complications.
Have the support of your family and friends throughout the recovery process.

Conclusion

Whipple procedure is a complicated procedure that is performed to treat pancreatic cancer. The procedure may have many complications but can be managed with proper medications and follow-ups.