The pancreas has been transected at the level of the portal vein and the pancreatic head is reflected laterally, allowing identification of small venous tributaries from the portal vein and superior mesenteric vein (SMV). These tributaries are ligated and divided. CHA, common hepatic artery.

What is removed in Whipple procedure?

During this procedure, surgeons remove the head of the pancreas, most of the duodenum (a part of the small intestine), a portion of the bile duct, the gallbladder and associated lymph nodes. In some cases, the surgeon may remove the body of the pancreas, the entire duodenum and a portion of the stomach.

What does Whipple resection consist of?

In a standard Whipple procedure, the surgeon removes the head of the pancreas, the gallbladder, the duodenum, a portion of the stomach and surrounding lymph nodes. The surgeon then reconnects the remaining pancreas and digestive organs.

How many anastomosis does a Whipple have?

In the procedure, the head of the pancreas and adjacent duodenum is resected. The gallbladder is also removed. Three anastomoses are then created between the bowel and the liver, stomach, and pancreas.

Which vein can be identified during the Whipple procedure and followed in order to identify the superior mesenteric vein?

The portal vein is identified above the pancreatic neck and the superior mesenteric vein is identified inferior to the pancreatic neck.

The Whipple Procedure | Johns Hopkins Medicine

42 related questions found

Why do a cholecystectomy in the Whipple procedure?

The Whipple procedure (pancreaticoduodenectomy) is an operation to remove the head of the pancreas, the first part of the small intestine (duodenum), the gallbladder and the bile duct. The remaining organs are reattached to allow you to digest food normally after surgery.

What are the steps in a Whipple procedure?

Inspection/Identification of Structures behind Duodenum

1. Determine if any lymphadenopathy is present.
2. Inspection and palpation of superior mesenteric artery.
3. Inspection of common bile duct.
4. Inspection of transverse mesocolon with mobilization of omentum off of transverse mesocolon and colon.

Does the pancreas grow back after surgery?

We conclude that the human pancreas does not regenerate after partial anatomic (50%) resection.

What is the average life expectancy after a Whipple procedure?

Overall, the five-year survival rate after a Whipple procedure is about 20 to 25%. Even if the procedure successfully removes the visible tumor, it's possible that some cancer cells have already spread elsewhere in the body, where they can form new tumors and eventually cause death.

How do you treat a leaky pancreas after Whipple?

According to our experience, recommended approach for this condition includes pancreatic debridement, closing its stump, resection of extra parts of the jejunum, closing the jejunal stump and feeding tube jejunostomy. Complete drainage of the abdomen and nutritional support after the surgical intervention.

How long did Steve Jobs live after Whipple surgery?

After a delay of nine months after diagnosis, in 2004, Jobs opted for surgery. He died 7 years later.

What are the long term side effects of the Whipple procedure?

But a Whipple procedure is a very complex operation that often causes major changes to the digestive system. This can translate into some serious long-term effects, including abdominal discomfort, weight loss, digestive problems, and chronic fatigue.

Is there an alternative to the Whipple procedure?

Based on this experience, I believe that the duodenum-preserving pancreatic head resection and the Frey procedure both offer better alternatives than the Whipple operation for patients with benign disease.

Can a pancreatic mass be benign?

Benign and precancerous growths in the pancreas. Some growths in the pancreas are simply benign (not cancer), while others might become cancer over time if left untreated (known as precancers).

What is the hardest surgery to perform?

7 of the most dangerous surgeries

• Craniectomy. A craniectomy involves removing a fraction of the skull to relieve pressure on the brain. ...
• Thoracic aortic dissection repair. ...
• Oesophagectomy. ...
• Spinal osteomyelitis surgery. ...
• Bladder cystectomy. ...
• Gastric bypass. ...
• Separation of conjoined twins.

How do you gain weight after Whipple surgery?

Eating six to eight small meals/snacks throughout the day.
...
For carbohydrates:

1. Pasta and grains, like farro and barley (great as an addition to soups)
2. Cereal (as a meal or snack)
3. Dried fruit.
4. Granola.
5. Wheatgerm.
6. Smoothies.
7. Potatoes/sweet potatoes.
8. Winter squash.

Is the Whipple a cure?

The Whipple procedure is the only known cure for pancreatic cancer and is usually performed on patients with cancer that has not spread beyond the pancreas.

Is chemo necessary after Whipple surgery?

You should be offered chemotherapy after surgery (such as the Whipple's procedure) to try to reduce the chances of the cancer coming back. Gemcitabine with capecitabine (GemCap) is used most often after surgery.

Can you drink alcohol after Whipple surgery?

If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.

Where do they cut you for pancreas surgery?

This typically requires a large incision (cut) in the abdomen, and it can take weeks to recover from this. Sometimes surgery can be done through several small cuts in the abdomen using special long surgical tools. (This is known as laparoscopic or keyhole surgery.)

What are the side effects of pancreatic surgery?

After pancreatic surgery, it is normal to have difficulty eating or to experience nausea, vomiting or heartburn. These symptoms are caused by a condition known as "gastric ileus," or temporary paralysis of the stomach. It may take your digestive system anywhere from a few weeks to a few months to return to normal.

How long does it take for a pancreatic leak to heal?

Once home, the full recovery is expected to take 6 to 8 weeks. Your body has to work hard to recover from the operation, and many patients will feel fatigued. During this period of time, patients struggle the most with eating.

Why is Whipple surgery so difficult?

Whipple procedures are complicated because they involve so many different organs, but that's not the only reason. “The pancreas is located in a very difficult spot, deep in the central part of the abdomen,” Reddy explained.

How complicated is bile duct removal surgery?

Any surgery on the bile duct itself is complicated because the anatomy of the liver is complex and because the duct is very closely associated with the blood vessels that are connected to the gallbladder and liver. The liver carries out hundreds of different functions, so its blood supply is very rich.

What hospital does the most Whipple surgeries?

Mayo Clinic surgeons are experts in the Whipple procedure, every variation of it and other pancreatic operations. Each year Mayo Clinic surgeons perform over 450 such surgeries.