Surgical treatment of diseases of the first part of the pancreas, called the head, require a complex surgical procedure called a pancreaticoduodenectomy or Whipple procedure. This surgery is performed by specially trained surgeons. It can be performed for diseases including cancer and pancreatitis as well as other disorders of the intestine, bile duct or pancreas.
What is involved?
During this procedure, the surgeon removes the head of the pancreas, the duodenum (the first part of the small intestine just past the stomach), a portion of the bile duct from the liver, and the gallbladder. Lymph nodes draining this area are also removed and evaluated. The gastrointestinal tract is then reconstructed, reconnecting all the divided structures to the intestines. The surgery takes several hours depending on the reasons for operating and the relationships to the surrounding blood vessels. In some specialty centers, like Mission Hospital, this surgery can be performed utilizing a robotic or minimally invasive approach speeding recovery. This method uses small incisions and special instruments to spare a large incision. This is a unique offering at Mission Hospital in addition to the traditional approaches which are used with complex tumors or problems.
See below for an (awesome) explanation with Play Doh and a video from Mayo Clinic
What will recovery be like?
Most patients will spend 7-10 days in the hospital after surgery. Following surgery a diet will slowly be resumed and activity increased daily. Delays in discharge are often related to non-healing of the new connections to the intestines or the stomach being slow to return to normal function. Some patients will go to rehab or another facility to help regain additional strength before going home. Temporary feeding tubes are sometimes used when a difficult recovery is anticipated.
Life after a Whipple
Recovery in some cases can take up to 2-6 months but most patients will progress much quicker. Thankfully, our practice and Mission Hospital have every available resource to help speed recovery as much as possible. Additional follow up and care is largely dictated by the underlying disease process. Completely normal recovery is seen in most patients despite the complexity of the surgery.
Jesse Sulzer MD PhD 