Pancreaticoduodenectomy (Whipple Procedure)

What is Pancreaticoduodenectomy?

Pancreaticoduodenectomy, also called Whipple procedure is the most common procedure performed to remove tumors in the pancreas. The procedure also involves removing and reconstructing a large part of the gastrointestinal tract. This surgery is a difficult and complex procedure. It can have serious risks.

In the standard Whipple procedure, the gallbladder, the head of the pancreas, the duodenum, a portion of the stomach and surrounding lymph nodes are removed. The surgeon then connects the remaining digestive organs.

Why does a patient need Pancreaticoduodenectomy?

If the patient has the tumor in the head of the pancreas and it has not spread to other areas of the body, the doctor will recommend pancreaticoduodenectomy to remove the tumor surgically. In most of the cases where this procedure is recommended, the tumor is cancerous.

This surgical procedure is also a treatment option for disorders of the pancreas, intestine and bile duct. Some of the conditions for which this procedure would be recommended are:

  • Pancreatitis
  • Pancreatic cancer
  • Pancreatic tumors
  • Pancreatic cysts
  • Neuroendocrine tumors
  • Small bowel cancer
  • Ampullary cancer
  • Bile duct cancer
  • Trauma to pancreas
  • Trauma to small intestine

What are the different types of Pancreaticoduodenectomy?

The different types of Whipple procedure are:

Open surgery: Given the complexity of Whipple procedure, open surgery is usually preferred. The surgeon will make an incision in the abdomen to access the pancreas. Based on the location of the cancer and its stage he will remove the affected parts and reconstruct the remaining ones.

Laparoscopic surgery: In this method the surgeon will make several smaller incisions in the abdomen. He will insert special instruments and a laparoscope with attached to it through the incisions. He watches the monitor to guide the surgical tools and performs the Whipple procedure.

Robotic surgery: Robotic surgery is a minimally invasive surgery. Here the surgical tools are attached to a robot. The surgeon controls the robot with the help of a console.