Table of contents:
- Conditions Treated by Whipple Operation
- Whipple Operation Procedure
- Whipple Operation Complications
- Treatment After Whipple Surgery
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. This is because pancreatic cancer can grow and spread to other organs without causing any symptoms, making it 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 have the potential to be curative. Patients who successfully undergo Whipple surgery have a 5-year survival rate of up to 25%.
Conditions Treated by Whipple Operation
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 cancer
- 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
- Cancer of the ampulla of Vater, 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 duct
- Neuroendocrine tumors, namely tumors that form in hormone-producing (endocrine) cells and in nerve cells
- Duodenal cancer, which is cancer that grows in the early part of the small intestine
Whipple Operation Procedure
When the operation is about to start, the patient will be under general anaesthesia so as not to feel any 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 continued with reconstructive surgery to reconnect the remaining digestive organs. This whole 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:
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.
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.
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 offers several advantages, namely a lower risk of bleeding and faster recovery after surgery. Disadvantage, this operation process is longer than open operation, and if there is a problem during operation, open operation is still required to complete the operation.
Whipple Operation Complications
Whipple surgery is a major operation that can cause various complications, including:
- Weight loss due to lack of nutrition (malnutrition)
- stomach dysfunction
- Leaks at the junction of the intestine or bile duct
Treatment After Whipple Surgery
After undergoing Whipple surgery, patients can be treated in a regular inpatient ward or intensive care unit (ICU).
Ordinary inpatient 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.
Patients will also be advised to go on a special diet, and the diet will be relaxed slowly. Generally, patients can walk immediately 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.
Patients 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 their 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.
dr. Sonny Seputra, M.Ked.Klin, Sp.B, FINACS(Surgeon Specialist)