What is a Pancreaticoduodenectomy?

A pancreaticoduodenectomy is a surgical procedure performed to excise cancerous tumors from the pancreas, gallbladder, bile ducts, or the upper part of the small intestine called the duodenum. During the procedure, a surgeon removes the entire gallbladder and sections of the other organs involved, and then sutures the remaining tissue together to restore the digestive tract. The surgery is delicate and takes a great deal of skill on the part of the surgical team, but modern technology and knowledge allows experts to complete procedures in about four hours with a very high success rate.

Also called the Whipple procedure in honor of the first surgeon to perform it, the pancreaticoduodenectomy has become one of the most effective forms of treatment for gastrointestinal cancers. The surgery is occasionally performed to treat other conditions that negatively impact pancreatic functioning, such as a benign tumor, a deformed bile duct, or chronic pancreatitis. Doctors usually reserve the treatment for patients over the age of 18, since operating on the organs may lead to developmental complications in growing children and adolescents.

During a traditional pancreaticoduodenectomy, after anesthesia is administered, the surgeon makes a long incision in the abdomen, and identifies the affected organ or section of tissue. Drugs to temporarily slow or block blood flow to the area are commonly used, though some patients still lose enough blood to require transfusions during the procedure. The gallbladder and duodenum are usually removed in their entirety, while only the head of the pancreas, bottom tip of the stomach, and lower end of the common bile duct are excised. The section of intestine further down from the removed duodenum, the jejunum, is typically sutured directly to the remaining sections of the pancreas, stomach, and bile duct. Once the surgeon confirms the success of the pancreaticoduodenectomy, he or she stitches the surgical scar and sends the patient to an intensive care unit.

Following a pancreaticoduodenectomy, the patient is usually kept in the hospital or surgical center for several days so doctors can monitor recovery. An individual may need to be placed on a mechanical ventilator and given a specialized feeding tube to avoid irritating the stomach and jejunum until they have time to heal. After one to two weeks, the tube is removed and the patient can usually go home if he or she is feeling well.

Most people who undergo the procedure experience excellent recoveries. Doctors usually schedule regular checkups to ensure the long-term success of procedures. If cancer remains in the gastrointestinal tract or spreads to other parts of the body, an individual may need to undergo chemotherapy or radiation treatments.