Pancreatic cancer is one of the leading diseases that do not show symptoms at an early stage and therefore threaten life when caught at an advanced stage. With Whipple Surgery, patients can regain their health.
Today, Whipple surgery, which is applied in appropriate events and experienced centers, provides successful results in the treatment of pancreatic cancer. With the chemotherapy treatment performed after Whipple surgeries, which are preferred for tumors of the head of the pancreas, bile ducts close to this region, and duodenum, the quality of life and duration of the patients increase. Assoc. Dr. Türkmen Bahadır Arıkan gave information about Whipple surgeries.
The Pancreas Regulates The Body’s Sugar Level
The pancreas, which is a very valuable organ for human life, is located in the body in a structure that extends from the back of the stomach to the spleen and is surrounded by the duodenum. The middle part is called the “neck” or “trunk” and the thin end is defined in the form of the “tail”. The pancreas produces enzymes that digest proteins, carbohydrates and fats that come from the stomach to the duodenum and discharge them into the duodenum. Insulin is the hormone that controls blood sugar level.
Ranks 4th in Cancer-Related Deaths
An uncontrolled growth and tumor formation in the pancreas is called pancreatic cancer. The tumor arises in the head 75% of the pancreas and the rest in the neck or trunk. It is assumed that pancreatic cancer, which ranks 4th in cancer-related death toll, will rise to 2nd rank in 2030. In the USA, approximately 57 thousand people are diagnosed with pancreatic cancer every year and approximately 46 thousand patients die.
Surgeries Applied in Pancreatic Cancer:
- For tumors or cysts in the body and tail of the pancreas, surgery to remove the left side of the pancreas (body and tail) is called “distal pancreatectomy.” During this procedure, the spleen can also be removed during the operation.
- In some pancreatic tumors, it may be necessary to remove the entire pancreas. This is called a “total pancreatectomy”. Humans can live without a pancreas, but longevity will require insulin and enzyme replacement.
- Pancreatic tumors can also affect vital blood vessels that pass near them. If the tumors involve nearby blood vessels, the patient is evaluated by the multidisciplinary committee (oncologist, radiologist, gastroenterologist and general surgeon specializing in pancreatic surgery), depending on the degree of vascular involvement, surgery and then chemotherapy may be considered. The procedure of removing and re-suturing the involved vessel with direct surgery can also be applied. Patients with extensive vascular involvement are not suitable for surgery and chemotherapy treatment is planned.
What is Whipple Surgery?
Whipple surgery, also known as “pancreaticoduodenectomy”, is a complex operation to remove the head of the pancreas, the first part of the small intestine (duodenum), gallbladder, and bile duct.
- It is performed to treat tumors and other disorders in the pancreas, intestine, and bile duct.
- It is the most commonly used surgical technique to treat pancreatic head cancer.
- It is a life-saving surgical formula for patients diagnosed with cancer.
- It is a treatment option used to stop the spread (metastasis) of cancer to other organs.
While Whipple surgery can be performed for approximately 15% to 20% of patients diagnosed with pancreatic cancer, another 15% of patients become eligible for surgery after chemotherapy treatment. Whipple, which is a very complex surgery, should be performed in a surgeon and center experienced in this field, as it will bring significant risks.
How Is Whipple Surgery Performed?
Whipple surgeries are wide-ranging operations that last 4-8 hours and which technique to use is decided according to the condition of the patient and the tumor. It can be performed in two ways:
- Open surgery: During open surgery, the surgeon creates an incision in the abdomen to access the pancreas. This is the most common and most practiced approach.
- Laparoscopic surgery: During closed laparoscopic surgery, the surgeon makes several small incisions in the abdomen and performs the surgery with the help of special instruments, including a camera that transmits the view to a monitor in the operating room. The surgeon watches the monitor to guide the surgical instruments while performing the operation. Laparoscopy is a type of minimally invasive surgery.
In minimally invasive surgery; blood loss is less and the risk of complications is also reduced. It is a comfortable system that enables the patient to become beautiful in a shorter time. Although the operative time is long, sometimes this procedure may begin with minimally invasive surgery, but complications or technical difficulties may require the surgeon to make an open incision to complete the operation.
In Which Situations Is Whipple Surgery Performed?
- pancreatic cancer
- Pancreatic cysts
- Pancreatic tumors
- Ampulla cancer
- Bile duct cancer
- Neuroendocrine tumors
- Twelve Fingers (Duodonum) Cancer
- Trauma to the pancreas or small intestine
- Other tumors or disorders involving the pancreas, duodenum, or bile ducts.
Close Follow-up is Important After Whipple Surgery
After surgery, the patient must be hospitalized in the general surgery service for at least one week. All surgical team and nursing staff will monitor the patient for signs of infection or complications to keep his condition under control. The diet will progress as slowly as tolerated. More than one patient can walk quickly after the operation. In some cases, a few days of intensive care unit stay may be required depending on the surgery and the patient’s condition. ICU doctors and nurses will monitor the patient’s condition to monitor for signs of complications. (BSHA-Science and Health News Agency)