A Whipple procedure is also called a pancreaticoduodenectomy, and is a major surgical operation performed for the treatment of pancreatic cancer. In the United States, 29,000 people are diagnosed with adenocarcinoma of the pancreas each year; it's the most common type of cancer of the pancreas. Unfortunately, about 28,000 people also die annually from this disease, which is the fourth leading cause of cancer deaths in men and women in the United States.
Definition
A Whipple procedure is an extensive surgical operation that includes the removal of the head of the pancreas, the duodenum and a portion of the stomach, along with other surrounding tissues. The mortality rate for Whipple procedures during the period between 1960 and 1970 was not favorable: The death rate was 25 percent. Today, the Whipple operation is highly regarded as a safe procedure, with a death rate lower than 4 percent.
History
The Whipple procedure as a treatment for pancreatic cancer was developed by Allen Whipple (1881-1963), an American surgeon who was on the faculty of Columbia University's College of Physician and Surgeons and on the surgical staff of New York City's Presbyterian Hospital. Whipple was a leader in abdominal, gall bladder and spleen surgery. He described the first Whipple operation in the 1930s.
Considerations for Surgical Procedure
Pancreatic cancers that have metastasized (spread) to other organs and into the lymph nodes are not considered for surgical treatment. Your physician will recommend surgery for tumors in the head of the pancreas, which is called a pancreaticoduodenectomy. Surgery for a tumor in the tail or a small portion of the body of the pancreas is called a distal pancreatectomy. These procedures require a 10-day hospital stay and an extended postoperative recovery period.
The Procedure
A Whipple procedure involves the resection of the head of the pancreas, a portion of the bile duct and the gall bladder, along with the duodenum and sometimes the resection of a portion of the stomach. The remaining pancreas, the bile duct and the stomach are then sewn back into the intestines, allowing the gastrointestinal secretions to be directed into the gut.
New Technique
With the popularity and success of laparoscopic procedures on the rise, Dr. Dilip Parekh, at the University of Southern California, is developing techniques for a laparoscopic Whipple operation, as an option for select patients with chronic pancreatisis, cystic tumors and islet cell tumors of the pancreas, and also for patients with ampullary cancer. The laparoscopic Whipple operation is not being offered for pancreatic adenocarcinoma at this time.
Considerations
A Whipple operation is a highly specialized procedure. The American Cancer Society highly recommends that it be performed in a center that is experienced and does a large number of these complex procedures, to ensure the highest chance of success.
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