WHIPPLE- Removal of the head of the pancreas for cancer or chronic pancreatitis

The Whipple procedure, also called pancreaticoduodenectomy, is a technicaaly intricate procedure that should be performed by specialists in this area. The Whipple procedure or pancreaticoduodenectomy is an operation to remove a part of the pancreas known as the head.

The head of the pancreas may need to be removed for a variety of reasons, such as a tumor of the pancreas, tumor of the bile duct, or inflammation of the pancreas or chronic pancreatitis.

Pancreas

The pancreas is a gland about six inches by two inches located in the back of your abdomen behind the stomach and is divided in three parts: the head, the neck and the body. The head lies surrounded by the first part of the small intestine called the duodenum. The body lies behind the stomach. The tail is on the left side next to your spleen.


The pancreatic duct, which carries digestive enzymes, runs along the entire length of the pancreas. The enzymes empty into the duodenum through an opening called the Ampulla of Vater. Two major bile ducts come out of the liver and join to form the common bile duct. The end of the common bile duct meets with the pancreatic duct at the Ampulla of Vater and empties bile into the duodenum. If a tumor develops in the head of the pancreas it can block the common bile duct and you will become jaundiced. Your skin and the white of your eyes might become yellow, your urine will become dark and your stools might become light in color.

The pancreas secretes hormones and enzymes. Insulin and Glucagon are the hormones, which regulate blood sugar level. Pancreatic enzymes help digest food, especially fat. Removing part of your pancreas does usually not affect your blood sugar levels. It is sometimes possible that the remaining pancreas does not make sufficient enzymes. In that case enzyme replacement can be taken as pills with every meal.

Operation

In order to remove a tumor in the head of the pancreas it is necessary to remove the head of the pancreas, the duodenum, the gallbladder and the end of the common bile duct. Sometimes, a part of the stomach is also removed. The end of your bile duct and the remaining pancreas are then connected to the small bowel to ensure flow of bile and enzymes into your intestines.
The procedure takes 4-6 hours and patients stay an average of 8-10 days in the hospital after pancreaticoduodenectomy.