The Whipple procedure is a major operation used for selected diseases of the pancreatic head and periampullary region.
When is it considered?
It is most often considered for pancreatic head adenocarcinoma and may also be used for distal bile duct cancer, ampullary tumors and selected duodenal or pancreatic lesions.
Preoperative planning
Preoperative planning evaluates vascular involvement, distant disease, nutritional status, jaundice and overall fitness. In some cancers, systemic therapy may be planned before surgery.
General principle of the operation
In a standard operation, the pancreatic head, duodenum, gallbladder and distal bile duct are removed. The pancreas, bile duct and digestive tract are then reconstructed with the small intestine.
General postoperative course
Recovery requires close monitoring typical of major abdominal surgery. Nutrition, pancreatic enzyme needs, glucose control, drains and wound healing are assessed.
Possible risks and complications
Potential complications include pancreatic fistula, delayed gastric emptying, bleeding, infection, bile leakage and general surgical/anesthetic complications.
