Whipple procedure is also termed as pancretoduodenectomy and it is performed for removing the pancreas head, the place, where the tumors are usually occurred. The procedure is an integrated procedure, as it involves removal of the surrounding organs, like parts of gallbladder, small intestine, bile ducts and in some cases, a small portion of the stomach. The remaining pancreas, bile duct and rest of the intestine are to be reconstructed during the reconstruction process. The procedure is the most effective procedure to treat pancreatic cancer. The procedure is also useful for the treatments of benign pancreatic lesions, bile duct caners, cysts and small parts of intestine.
Pancreas has the physiological function of secreting the enzymes and hormones. The secreted hormones, like glucagon and insulin are for maintain the normal levels of the blood sugar. The enzymes are used to break the food down and help the food to digest fat.
The need for Whipple is for the following.
- Cancer of the duodenum
- Cholangiocarcinoma, which is bottom end of bile cancer
- Head of pancreas cancer
- Cancer of ampulla
- Sometimes for benign disorders, like benign tumors present in pancreas head and chronic pancreatitis
Pancreatic cancer patients, who have their tumors confined only at the pancreas head and not yet spread to the surrounding major blood vessels are only eligible for the Whipple procedures, but not all the pancreatic cancer patients.
There are two kinds of pancreatic cancers.
- Exocrine Tumors
Adenocarcinomas are most of the tumors that affect the exocrine gland. Such cancer is formed usually in the pancreas ducts. Major, in fact about 95% of the these pancreatic cancers are started with pancreas’s exocrine cells.
- Endocrine Tumors
These tumors are mostly of benign and are also very less common. When the cancer stems from the PET or Pancreatic Endocrine Tumor, the hormone producing cells are affected, through it is rarely happened. These tumors are also named as neurendocrine orislet cell tumors.
Type of Whipple Procedures for Pancreatic Cancer
There are different procedures performed in Whipple Procedures.
- Standard Procedure
The standard Whipple procedure involves the removal of the pancreas head, small duodenum part, which is small intestine upper part, gallbladder and also pylorus, which is a small part of stomach. After the procedure, the digestive organs and pancreas are reconnected back. So, the bile, digestive enzymes of pancreas and stomach will start flowing during the digestion, towards the small intestine.
- Pylorus Preserving Procedure
Pylorus preserving Whipple procedure is another Whipple procedure performed at pylorus or bottom part of the stomach. The procedure involves removal of the PPPD or Pylorus Preserving Pancreaticoduodenectomy.
Laparoscopic Whipple Procedure
Whipple Procedure can also be performed as a laparoscopic procedure. Six small incisions are done over the abdominal wall to perform this procedure. A thing and tube that consists of a camera at the tip is called a laparoscope and this tube is inserted through one of the six incisions made. The laparoscope helps to view the internal structure of the surgical site, so that the procedure can be performed accurately. Other small surgical instruments are inserted through the remaining incisions to perform the surgery.
Whipple Procedure Effect on Diabetes
When the Whipple procedure is performed the risk of diabetes development can exist. It is because the pancreatic tissue has to be removed in the procedure, which may stop producing enough insulin.
Cost of Whipple Surgery for Pancreatic Cancer
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