What does a Whipple Operation entail?
The whipple operation involves “removing the head of the pancreas”. As you will note from the illustration, the common bile duct, the ampulla, the duodenum are all integrally related to the head of the pancreas and all share their blood supply. Therefore the Whipple operation is a fairly complex operation removing portions of all these structures and then re-hooking these back up to a new loop of intestine. Dr. Allen Whipple was a Professor of Surgery at Columbia University in New York City who popularized this operation in the early 30’s. It has since undergone several minor modifications and therefore goes by different names. It is an operation that should only be done by experienced surgeons who do these routinely. Dr. Singh has been doing this operation for over 15 years with excellent outcomes. The average hospital stay ranges from 7-14days.
Can the Whipple Operation be done with Vein or Arterial Reconstruction?
Yes. Sometimes with locally advanced cancers of the head of the pancreas, the portal vein or superior mesenteric vein is involved or the tumor is closely abutting these structures. Most surgeons are reticent to perform such a technically, demanding and challenging operation. These patients are often referred for chemotherapy or radiotherapy.
It is imperative that patients seek a second opinion, because if the vein can be resected to negative margins and reconstructed, they have a significantly much better prognosis. Dr. Singh is routinely doing vascular reconstructions with the Whipple operations, when indicated. While the venous reconstruction can be done routinely, arterial reconstructions are more challenging and have to be embarked upon very selectively on a case by case basis, and is dependant on tumor type and aggressiveness. Over 50% of the cases seen at the John Wayne Cancer Institute, St. John’s Health Center are cases turned down by surgeons from all over the country; and a good majority of these are resected to negative margins.
Bloodless/Transfusion Free Surgery
Whenever feasible we try to minimize the possibility of using blood or blood products. As remote as it may seem, blood can never be considered 100% safe. Despite all the state of the art tests done on the transfusion units, there is always a theoretical possibility of transmission of an unknown organism/ disease. Dr. Singh, has published extensively on “blood conservation” and “transfusion free surgeries”, and it continues to remain an important focus for him and his team. Related Links:
When is a Whipple done? Pancreatic Cancer What is Distal Pancreatectomy? |