ABOUT WHIPPLE PROCEDURE
A whipple procedure is a surgical procedure performed to remove part of the pancreas, bile duct, duodenum, gallbladder and stomach. The procedure is most commonly performed to treat pancreatic cancer, however it is also performed to remove tumors and treat chronic pancreatitis.
The pancreas is located behind the stomach and is divided into 3 main parts, the head, body, and tail. The head of the pancreas, where cancer can develop, is connected to the duodenum. Its function is to produce enzymes, which break down food and absorb nutrients, as well as to produce insulin to regulate blood sugar and glucose in the blood.
Pancreatic cancer is often advanced when it is first found, as the initial stages of pancreatic cancer do not usually cause symptoms, making it difficult to detect. Once diagnosed, a Whipple procedure is usually recommended as it can provide the best chance of curing the cancer. For patients with pancreatic cancer who are not suitable candidates for the Whipple procedure, chemotherapy is the treatment used as an alternative. Chemotherapy may also be used in conjunction with the Whipple procedure when treating pancreatic cancer.
Once part of the pancreas and neighboring organs have been removed, the remaining part of the pancreas is then reattached to the intestine so that it can function again. The procedure is performed under a general anesthetic and patients will be need to stay in the hospital for 10 to 14 days.
Recommended for
- Pancreatic cancer
- Tumor in the pancreas
- Bile duct cancer
- Duodenum cancer
- Chronic pancreatitis
TIME REQUIREMENTS
- Number of days in hospital: 10 – 14 days.
- Average length of stay abroad: 2 – 4 weeks.
After the hospital stay, patients should rest before traveling, in order to allow their body some time to heal.
- Number of trips abroad needed: 1.
HOW TO FIND QUALITY TREATMENT ABROAD
BEFORE WHIPPLE PROCEDURE ABROAD
Patients will meet with the surgeon ahead the of surgery to discuss the surgery and to address any questions or concerns that they may have. The doctor will conduct any necessary tests if they have not already been performed such as an ECG, blood pressure test, and blood tests.
Patients will be advised to refrain from eating and drinking in the hours preceding the surgery, in order to prepare for the general anesthetic.
HOW IS IT PERFORMED
Usually the Whipple procedure is performed as open surgery. The surgeon will begin my making a midline incision in the abdomen. The surgeon will then examine the abdomen to ensure that the tumor or cancer has not spread beyond the pancreas. As the pancreas is located deep into the abdomen, it is necessary to remove parts of the neighboring organs, in order to gain access to the pancreas.
The bile duct is divided and the duodenum is then divided, in some cases the surgeon may remove a small portion of the stomach. The neck of the pancreas is divided to ensure that all of the tumor in the head of the pancreas is removed. There are 2 important blood vessels, the superior mesenteric artery and the superior mesenteric and portal vein, which the portion of pancreas needs to be removed from. If the tumor is connected to these vessels, part of the veins may also need to be removed. Part of the jejunum, a part of the duodenum, is then removed in order to create space for the pancreas and tumor to be removed through. The jejunum is then sutured back into place.
The remaining pancreas is connected to the small bowel, the bile duct is reconnected to the duodenum, and the stomach is then reconnected to the duodenum, in the cases where part of it was removed. The incision site is then closed with sutures and a sterile dressing is applied.
Anesthesia
General anesthetic.
Procedure duration
The Whipple Procedure takes 4 to 7 hours.
WHAT TO EXPECT AFTER WHIPPLE PROCEDURE
Post procedure care
After the procedure patients will be taken to the ICU where they will be closely monitored for the first 24 hours after the surgery. The patient will be connected to various tubes such as a catheter to drain urine, which will be removed as they begin to recover.
As the pancreas produces insulin to regulate blood sugar, patients who have the entire pancreas removed will have type 1 diabetes after the surgery. This means they will need to carefully regulate their diet, inject insulin daily, and continuously monitor blood sugar levels.
Possible discomfort
Patients will experience pain and discomfort after the procedure and will need to avoid strenuous activities in the weeks proceeding the surgery.
IMPORTANT THINGS TO KNOW ABOUT WHIPPLE PROCEDURE
Potential risks
- Adverse reaction to the general anesthetic
- Bleeding
- Infection
- Chest infection
- Diabetes