Whipple Procedure

Whipple procedure, also known as pancreaticoduodenectomy, is a common surgical procedure to remove the pancreatic tumour, tissues and lymph nodes surrounding the tumour, and affected parts of the pancreas. This procedure also engages in the removal of the nearby structures such as the duodenum (part of the small intestine), the pylorus (lower parts of the stomach), part of the common bile duct and the gall bladder. Whipple procedure also involves the reconstruction of a large part of the gastrointestinal tract, making it complex and challenging.

A slightly different version of the Whipple procedure, known as the modified or pylorus-preserving Whipple, is also performed. This procedure is the same as a standard Whipple procedure, but it preserves the pylorus in its place.

Eligiblity

• Chronic pancreatitis
• Pancreatic cancer
• Neuroendocrine tumours
• Duodenal cancer
• Cancer of the lower (distal) portion of the bile duct
• Ampullary cancer
• Small bowel cancer
• Trauma to the small intestine or pancreas

An individual with cancer restricted to the head of the pancreas, which has not spread to other areas of the body, and who is fit for the surgery can undergo a Whipple procedure. The person should not have any underlying medical conditions or factors which may affect the surgical process or the recovery process.

Malignancies in the pancreas, duodenum or bile duct are most often seen together, as certain enzymes pass through these complex connections to digest food in the duodenum. Therefore, during a Whipple procedure, these factors should also be considered to assess the spread of cancer.

Procedure

• Laparoscopic surgery: This is a minimally invasive technique, in which small incision is made on the abdomen to insert a probe with special instruments, including a camera. This helps to obtain a clear vision of the abdomen to perform Whipple procedure with surgical tools.
• Open Surgery: This is a commonly performed procedure. Incisions are made in the abdomen to access the pancreas and perform the procedure.
• Robotic Surgery: It is a new minimally invasive procedure. In this method, the surgeon controls the mechanical device (or robot) attached to surgical tools with a console nearby. The advantage of this method is that the robot can reach the corners and tight spaces where a human hand cannot reach.