Introduction
A Whipple procedure – also known as a pancreaticoduodenectomy – is a complex operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct.
The Whipple procedure is used to treat tumors and other disorders of the pancreas, intestine and bile duct. After the resection part of the procedure finishes, the second part consist of joining stomach, bile duct and pancreas to bowels to restore continuity.
Indications
Your doctor may recommend you have a Whipple procedure to treat:
- Pancreatic cancer.
- Pancreatic cysts.
- Pancreatic tumors.
- Pancreatitis.
- Ampullary cancer.
- Bile duct cancer.
- Neuroendocrine tumors.
- Small bowel cancer.
- Trauma to the pancreas or small intestine.
- Other tumors or disorders involving the pancreas, duodenum or bile ducts.
Preoperative Instructions
- Only take the important medications in the morning of the operation.
- The anti-platelets (Aspirin or Plavix) and the anti-coagulants (Warfarin, Pradaxa, Eliquis) need to be withheld as per your surgeon advice.
Procedure
A Whipple procedure may be done in various ways:
- Open surgery. During an open procedure, your surgeon makes an incision in your abdomen in order to access your pancreas. This is the most common approach and the most studied.
- Laparoscopic surgery. It is a minimally invasive, key-hole surgery and it is less commonly done for Whipple’s procedure.
- Robotic surgery. Being investigated for Whipple’s Procedure.
Postoperative Instructions
After your Whipple procedure, you can expect to:
- Stay in the intensive care unit (ICU) for a few days, indicated in most of our cases to optimize the care until the patient is fit enough to go to the surgical ward.
- Stay in the general surgical unit. Surgical team will review your case frequently and regularly to ascertain that your progress is satisfactory. Oral intake and mobility will be introduced gradually.
- Older adults and people with significant health concerns may require a temporary stay in a skilled rehabilitation facility.
- Most people can return to their usual activities four to six weeks after surgery. Delayed recovery can happen especially when the procedure was complicated or the patient of a borderline health.
Risks
- Bleeding.
- Wound infection or abdominal infected collections.
- Gastric emptying problem: if the stomach function is delayed, you may experience nausea or vomiting or varying severity until the problem is resolved.
- Pancreatic or bile leak.
