Whipple Procedure
Whipple Procedure (also called pancreaticoduodenectomy)
sometimes entails removal of the entire pancreas, called a total Whipple Procedure, but
more often involves removal of part of the pancreas, which is called a subtotal Whipple
Procedure, or distal Whipple Procedure, when the body and tail of the pancreas are
removed. When the duodenum is removed along with all or part of the pancreas, the
procedure is called a Whipple Procedure, which surgeons sometimes refer to as
"Whipple's procedure." Whipple Procedure is being used increasingly for
treatment of a variety of malignant and benign diseases of the pancreas.
Regional lymph nodes are usually removed during Whipple Procedure. In distal Whipple
Procedure, the spleen may also be removed.
Whipple Procedure is the most effective treatment for cancer of the pancreas
Whipple Procedure is the most effective treatment for cancer of the pancreas, an
abdominal organ that secretes digestive enzymes, insulin, and other hormones. The thickest
part of the pancreas near the duodenum (small intestine) is called the head, the middle
part is called the body, and the thinnest part adjacent to the spleen is called the tail.
While surgical removal of tumors in the pancreas is preferred, it is only possible in
the 10-15% of patients who are diagnosed early enough for a potential cure. Patients who
are considered suitable for surgery usually have small tumors in the head of the pancreas
(close to the duodenum, or first part of the small intestine),have jaundice as their
initial symptom, and have no evidence of metastatic disease (spread of cancer to other
sites).
Other reasons a Whipple Procedure is performed
Whipple Procedure is sometimes necessary when the pancreas has been severely injured by
trauma, especially injury to the body and tail of the pancreas. While such surgery removes
normal pancreatic tissue as well, the long-term consequences of this surgery are minimal,
with virtually no effects on the production of insulin, digestive enzymes, and other
hormones.
Chronic pancreatitis is another condition for which Whipple Procedure is occasionally
performed. Chronic pancreatitis--or continuing inflammation of the pancreas that results
in permanent damage to this organ--can develop from long-standing, recurring episodes of
acute (periodic) pancreatitis. This painful condition usually results from alcohol abuse
or the presence of gallstones. In most patients with alcohol-induced disease, the pancreas
is widely involved, therefore, surgical correction is almost impossible.
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