The Whipple operation starts with the removal of not only the pancreas head, but also parts of the small intestine, gall bladder, bile duct, and part of the stomach. Next, the pancreas cancer surgeon reattaches all the remaining parts of the pancreas and digestive organs, in order to facilitate recovery of normal activity of the digestive system.
The Whipple operation may be done traditionally (open) or laparoscopically, depending on several factors, such as the extent of disease, and the overall health condition of the patient.
Open Whipple Procedure: For a standard, open Whipple procedure, a transverse incision is made on the abdomen, and the abdominal cavity is first checked thoroughly for signs of metastasis. If the cancer has spread to other abdominal organs or invaded major vessels, the patient may be referred to a liver cancer surgeon for further evaluation.
But if no other organs are affected, the Whipple surgeon will then proceed to remove the head of the pancreas, the first part of the small intestine (duodenum), lower part of the stomach, gallbladder and bile duct. Typically, the surrounding lymph nodes will be removed for adequate staging of disease. Certain cases may require vascular reconstruction of major vessels if the tumour is close to the blood vessels, or if the tumour has invaded the blood vessels.
After removal of the pancreatic tumour, reconstruction will be required. This involves reconnection of the remaining parts of the stomach, pancreas and intestines to facilitate digestive processes.
Laparoscopic Whipple Operation: Laparoscopic Whipple operation may be offered to some individuals, where the organs are accessed and removed through several small incisions in the abdomen with the help of a monitor and a light-and-camera-assisted scope.
Compared to traditional open surgery, this method results in smaller incisions and less wound pain. It takes several hours to perform which is similar to open Whipple operation.