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Operations of the Pancreas
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What does 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.
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What is a distal pancreatectomy?
Distal pancreatectomy is the removal of the tail of the pancreas. When a distal pancreatectomy is performed to remove a cancer, often the surgery (operation) also includes the removal of the spleen in conjunction with the tail of the pancreas since the arteries and veins to the spleen are integrally related to this portion of the pancreas. For non-cancerous cases, a spleen preserving distal pancreatectomy can be performed.
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What is a central pancreatectomy?
This is a rather uncommon and fairly complex operation of the pancreas and includes removal of the central portion of the pancreas. Unfortunately, because of anatomical reasons it is not possible to connect the 2 ends of the pancreas. Continuity is reestablished by bringing up a loop of small intestine to connect the 2 ends of the pancreas.
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Enucleation is similar to shelling the tumor out of the pancreas and leaving the normal pancreas behind. This sort of an operation is done for very few conditions of the pancreas such as an insulinoma. This is not a cancer operation and hence not the norm for aggressive cancers.
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