The pancreatoduodenectomy or Whipple procedure, as it is known indiscriminately, continues to be the only treatment option with curative intent for periampullary tumor disease, which includes pancreatic adenocarcinoma, distal cholangiocarcinoma, ampullary adenocarcinoma and duodenal adenocarcinoma.
The advances that have been achieved over the years in medicine and especially in surgery have led to the adoption of new surgical techniques, as well as to have more and better technological tools, which have been applied in the case of pancreatic surgery.
Why Would Someone Need a Whipple Procedure?
Patients of pancreatic cancer choose Whipple procedure as it is a technique widely used in the treatment of pancreatic cancer since the quality of life of the patient improves significantly, despite the aggressiveness.
Whipple procedure duration is between 5 and 8 hours and the recovery of the patient, between 7 and 10 days.
Once pancreatic cancer has been identified and localized, the medical team usually chooses to perform this type of surgery. Thus, specialists can remove the tumor and increase the chances of survival of patients. However, this does not always guarantee the total cure of this kind of pathologies and the experts will review what the best treatment is for the patient.
First, a central incision of a moderate size is made in the abdomen (belly) of the patient and the organs of the area are checked. Thus, the surgeon can determine if cancer has spread and taken a sample for a biopsy.
However, experts may choose to use laparoscopy, a technique that requires various cuts in the abdominal area. Therefore, another name that the procedure receives is “minimally invasive surgery.”
Next, the head (and sometimes also the body) of the pancreas is removed along with other body structures. Also, the first part of the small intestine (the duodenum), the gallbladder and part of the bile ducts (or complete) are removed.
On the other hand, at other times specialists choose to also remove lymph nodes near the pancreas and even part of the stomach. After performing this procedure, the medical team links the bile duct and pancreas to the small intestine. In this way, bile produced in the liver and enzymes synthesized in the pancreas can participate in digestion in a normal way.
Finally, the Whipple procedure medical team reconnects the small intestine and stomach so that food flows as usual and treats the wound produced by the abdominal incision.
What Are The Risks of Whipple Procedure?
As a general rule, patients who undergo this Whipple procedure may suffer a series of adverse effects. Thus, the complications after the Whipple procedure are more common and serious if performed in a less specialized hospital than if it is carried out in oncological centers with experienced professionals.
For example, among the most frequent side effects of Whipple procedure we can highlight:
-Bleeding or hemorrhage formation in the area of the surgery.
-Development of diabetes. Also, it can appear temporarily or permanently.
-Difficulty to empty your stomach on your own after feeding. This causes the food to be retained in this organ longer than usual.
-Inappetence or loss of appetite. It also usually causes an unwanted weight loss in the patient.
-Pain or discomfort in the area where the incision was made.
-Formation of infection in the Whipple procedure operating region.
-Problems to perform the digestion of certain kinds of food. As a general rule, it appears during a reduced period of time and is solved with the administration of drugs with digestive enzymes to facilitate the process.
-Leaks between the organs that the medical team connects during the Whipple procedure surgical intervention. Also, the effects of this alteration vary depending on the location and severity that it presents.
Conclusion
Whipple type of procedure should be performed in centers with experience in open pancreatic surgery, with training in advanced laparoscopic surgery and following a strict protocol.
The real advantage of this approach for Whipple surgery is mainly focused on less transoperative bleeding and shorter hospital stay. It has proved to be effective to treat patients with pancreatic cancer.
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