How is Whipple surgery performed?

The Whipple procedure, also known as pancreaticoduodenectomy, involves several key steps to remove the head of the pancreas, a portion of the stomach, and nearby structures. Here is a general overview of the surgical process:

1. Pre-operative Preparation:

Before the surgery, the patient undergoes a comprehensive medical assessment to ensure they are fit for the procedure. This may include imaging studies, blood tests, and anesthesia evaluation.

2. General Anesthesia:

The surgery is typically performed under general anesthesia, where the patient is unconscious and pain-free during the procedure.

3. Incision:

The surgeon makes an incision in the abdomen, usually a horizontal cut just below the rib cage. In some cases, a vertical incision may be made.

4. Exploration and Assessment:

Once the abdomen is open, the surgeon examines the pancreas, bile ducts, and nearby organs to determine the extent of the disease and confirm the feasibility of the procedure.

5. Removal of the Pancreas Head:

The surgeon carefully separates the head of the pancreas from surrounding tissues, blood vessels, and ducts. The pancreas is then cut and divided at specific points to remove the affected portion.

6. Removal of the Gallbladder and Bile Duct:

The gallbladder and a segment of the bile duct are also removed during the surgery. These structures may be affected by tumors or blockages related to the pancreatic disease.

7. Reconstruction:

After removing the diseased tissues, the surgeon reconstructs the digestive system. This involves connecting the remaining pancreas, stomach, and small intestine to ensure proper digestion and passage of food. This is done by creating new connections (anastomoses) between these organs.

8. Drainage:

To prevent fluid buildup and infection, the surgeon may place temporary drainage tubes near the surgical site. These tubes will be removed once healing is complete.

9. Closure:

The abdominal incision is closed with sutures, staples, or surgical glue. Sterile dressings are applied to the wound.

10. Monitoring and Recovery:

After the surgery, the patient is taken to the recovery room for close monitoring. They may be given pain medication to manage discomfort. The patient's progress will be closely monitored in the hospital, and they may need to stay for several days to weeks depending on their recovery.

It is important to note that the specific details and techniques of the Whipple procedure may vary based on the surgeon's preference and the individual patient's condition.