Whipple surgery is surgery that involves removing part of the head of the pancreas, the first part of the small intestine (duodenum), part of the bile duct, gallbladder, and sometimes part of the stomach. Generally, this surgery is used to treat pancreatic cancer.
The pancreas is part of the human digestive system. This organ is behind the abdominal cavity, functions to produce hormones and enzymes to break down food. Anatomically, the pancreas is divided into 3 parts, namely the head, body, and tail.
One of the most dangerous diseases of the pancreas is pancreatic cancer. The reason is, pancreatic cancer can grow and spread to other organs without causing any symptoms so it is difficult to detect.
In addition, of all types of cancer, pancreatic cancer has the lowest life expectancy. Only about 6% of pancreatic cancer patients survive up to 5 years after being diagnosed with this condition.
In some patients with pancreatic disease (including pancreatic cancer that has not spread), Whipple surgery can prolong life and be potentially curative. Patients who successfully undergo Whipple surgery have a 5-year survival rate of up to 25%.
Conditions Treated with Whipple Surgery
In addition to treating pancreatic cancer that has not spread, Whipple surgery can also be used to treat the following diseases:
- Pancreatic cyst, which is a condition when a fluid-filled sac forms in the pancreas
- Intraductal papillary mucinous neoplasm (IPMN), which is a certain type of tumor that can grow in the head of the pancreas and has the potential to become cancerous
- Pancreatic tumor, which is a condition when a tumor grows in the pancreas, including some types of benign tumors
- Chronic inflammation of the pancreas, which is inflammation of the pancreas that permanently damages and stops the function of the pancreas
- Ampulla of Vater cancer, which is cancer that grows in the area where the bile duct meets the pancreas
- Bile duct cancer, which is cancer that grows in the bile ducts
- Neuroendocrine tumors, which are tumors that form in hormone-producing (endocrine) cells as well as in nerve cells
- Duodenal cancer, which is cancer that grows in the early part of the small intestine
Whipple Operation Procedure
When the operation will begin, the patient will be under general anesthesia so as not to feel pain during the surgical procedure.
During the operation, the doctor will remove the head of the pancreas, most of the duodenum (the first part of the small intestine), as well as some of the bile duct, gallbladder, and adjacent lymph nodes. In some cases, part of the stomach is also removed.
After that, the process is continued with reconstructive surgery to reconnect the remaining digestive organs. This entire surgical procedure usually takes about 7 hours.
Whipple surgery can be performed in three ways, namely open surgery, laparoscopic surgery, and robotic surgery. Here is the explanation:
Open operation
In open surgery, the doctor will make a wide incision in the abdomen to access the pancreas. This surgical technique is the fastest and most commonly performed in Whipple surgery.
Laparoscopic surgery
In laparoscopic surgery, the doctor will make several small incisions in the abdomen. The incision becomes the entry point for surgical equipment, including the camera used to guide doctors in performing Whipple surgery.
Robotic surgery
In robotic surgery, surgical instruments are attached to a mechanical device (robot) which is then controlled by a doctor. Robotic surgery allows doctors to reach narrow areas of organs.
Laparoscopic and robotic surgery offer several advantages, namely a lower risk of bleeding and faster recovery after surgery. The drawback is that this operation process takes longer than open surgery, and if there are problems during the operation, open surgery is still required to complete the operation.
Whipple Surgery Complications
Whipple surgery is a major surgery that can cause various complications, including:
- Diarrhea
- Weight loss due to nutritional deficiencies (malnutrition)
- Diabetes
- Gastrointestinal dysfunction
- Leaks at the junction of the intestine or bile duct
- Fistula
- Infection
- Bleeding
Treatment After Whipple Surgery
After undergoing Whipple surgery, patients can be treated in a regular inpatient ward or intensive care unit (ICU).
Ordinary hospital room
Most patients will be admitted to the general surgical care ward immediately after surgery. The length of hospitalization depends on the patient's condition, but is generally about 1 week. During hospitalization, the doctor will monitor the patient's progress several times a day and watch for signs of infection or other complications.
The patient will also be advised to go on a special diet, and the diet will be loosened slowly. Generally, patients can walk straight after surgery.
Intensive care unit (ICU)
If the patient has certain medical conditions, the doctor may advise the patient to be admitted to the ICU after surgery. The doctor will monitor the patient's condition continuously to watch for signs of complications.
The patient will be given fluids, nutrition, and drugs through an IV. In addition, the patient can also be fitted with a special tube to remove urine or fluid that has settled in the operating area.
Most patients can return to normal activities within 4–6 weeks after surgery. The length of time the patient recovers depends on his physical condition before the operation and the complexity of the operation. If any complaints arise after returning home, immediately consult a doctor .
Written by:
dr. Sonny Seputra, M.Ked.Klin, Sp.B, FINACS
(Surgeon Specialist)
