Whipple Procedure (Pancreaticoduodenectomy)

The Whipple Procedure is often used to remove a growth on the duodenum (the first section of the small intestine), bile duct, or head of the pancreas.  This procedure can also be performed to address chronic pancreatitis and strictures of the bile or pancreatic ducts.

How are Whipple Procedures performed?

This procedure is performed with general anesthesia.  At the beginning of the procedure, the doctor will determine whether the tumor can be removed.  The pancreas is examined by laparoscopic instruments or through an incision.  If the cancer has not spread to surrounding tissues the procedure can continue.

The main objective of the Whipple procedure is to remove the head of the pancreas and the attached section of the duodenum where they share blood supply.  Sometimes the gallbladder and a portion of the stomach are also removed.  First, the end of the stomach is divided off and detached. This part of the stomach leads to the duodenum, where the pancreas and bile duct are both attached. After that, the head of the pancreas is removed, leaving it attached to the duodenum. Farther down from the pancreas attachment site, the duoedenum is resectioned to free the part of the intestine that is connected to the pancreatic head. The bile duct is the last connection to be cut.

The next steps reconnect the intestinal tract. The stomach is connected to the small intestine, and the bile duct and remaining portion of the pancreas are reattached.

Several tubes may be implanted for postoperative care. To prevent tissue fluid from accumulating in the operated site, a temporary drain leading out of the body will be implanted. Also, a G-tube leading out of the stomach will be inserted to help prevent nausea and vomiting, and a J-tube inserted into the small intestine will serve as a channel for supplementary feeding.

What can I expect after surgery?

You will receive instructions on post-operative activity and suggestions for your diet.  You will need to reduce your activity for four to six weeks.  Patients may feel some pain and discomfort after the Whipple procedure. Eating and finding the right foods will be difficult for the first few weeks. You may also experience nausea and constipation.  While your digestive system is recovering, you will probably be unable to return to work and normal activities within the first month after surgery. After the first month, you will slowly begin to feel normal.

What are the risks associated with a Whipple procedure?

As with any surgery, there are risks such as bleeding, infection, or an adverse reaction to anesthesia. Biliary and pancreatic leaks may also occur. Because the pancreas will not function as effectively, postoperative diabetes and the occurrence of fatty stool may develop. This depends upon how much of the pancreas was removed.

Dr. Shyamali Singhal - General Surgery and Advanced Surgery.  Specializing in Surgical Oncology for the treatment of Cancer - Melanoma (Skin Cancer), Colon Cancer, Stomach Cancer, Liver Cancer, Pancreatic Cancer, Breast Cancer, etc.  Experienced Whipple Procedure surgeon.
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