Whipple Procedure: Who Should Have It?-Gastro Surgeon Explains

 Pancreatic cancer is still a difficult condition to treat, but surgery can sometimes remove pancreatic tumours before they spread to other parts of the body. The Whipple procedure, named after the surgeon who first described and performed it, is the most common surgery for pancreatic cancer, says a gastroenterologist surgeon in Kolkata.

Whipple surgery, also known as "pancreaticoduodenectomy," extracts the gallbladder and parts of the pancreas, small intestine and in some cases, the stomach. The Whipple procedure for pancreatic cancer is not for everyone. The surgery is difficult to recover from and the prognosis is uncertain.

Who Is An Ideal Candidate for the Whipple Procedure?

Although the Whipple method is most closely associated with pancreatic cancer, it can be used to treat a variety of other conditions, including:

• Ampullary cancer (a tumour that develops at the junction of the bile duct and the pancreatic duct)

• Bile duct cancer (tumors in the common bile duct)

• Small intestine cancer

• Chronic pancreatic inflammation (pancreatitis)

• Pancreatic cysts

• Neuroendocrine cancers (tumors in cells that possess both neurological and endocrine traits)

• Injury to the small intestine, pancreas, or nearby structures

According to the top gastro surgeon in Kolkata, the Whipple procedure is only considered for pancreatic cancer tumours that have not metastasized (spread) to other structures. A person with non-spreading pancreatic head tumours is a good candidate for the Whipple procedure.

Complications and Risks of the Whipple Procedure

Pancreaticoduodenectomy can be done in a variety of ways. The "classic" Whipple procedure involves the removal of the gallbladder, pancreatic head, bile duct, duodenum (first section of the small intestine) and sometimes a portion of the stomach. Alternative procedures may include removing the pancreas's middle and tail and the spleen and adjacent lymph nodes. One surgical approach preserves the pylorus—the stomach and the small intestine opening.

According to the GI surgeon in Kolkata, all of these surgeries are complex and there is a risk of complications such as:

• Bleeding

• Blood clots

• Diabetes (because the pancreas produces insulin)

• Infection

• Internal leakage of stomach contents or other fluids from surgical sites into the abdomen

• Stomach emptying problems

• Digestive malabsorption

Sometimes it is also possible that pre-surgical imaging studies and lab tests will not reveal the presence of metastasis in a pancreatic or other tumour. A surgeon may discover this only after opening the abdomen and, subsequently, the surgeon will be unable to perform the surgery, says the GI surgeon in Kolkata.