Our Summary

This research paper is about a surgical procedure called the Whipple procedure, which has traditionally been performed as an open surgery. However, with the advancement of technology, it’s now possible to perform this surgery using minimally invasive methods. The paper reports on the case of a 70-year-old man who underwent a full laparoscopic (minimally invasive) Whipple procedure to treat a type of cancer.

The surgery involved creating three connections (anastomoses) between different parts of the digestive system, which were done by hand-sewing method. The surgery took a total of 8 hours and 20 minutes to complete, and the patient lost about 350 cc of blood. The patient was able to leave the hospital after 9 days, and further tests confirmed that the surgery successfully removed the cancer.

The paper concludes that performing the Whipple procedure laparoscopically is an advanced method that offers several benefits over traditional open surgery, including less trauma to the abdomen, less postoperative pain, shorter hospital stays, improved comfort for the patient, and improved cosmetic results.

FAQs

  1. What is the Whipple procedure and how is it traditionally performed?
  2. What are the benefits of performing the Whipple procedure laparoscopically as opposed to traditional open surgery?
  3. How long did the full laparoscopic Whipple procedure take and what was the recovery process like for the patient?

Doctor’s Tip

One helpful tip a doctor might tell a patient about the Whipple procedure is to follow a strict post-operative diet plan. This typically includes starting with clear liquids and gradually progressing to soft, easily digestible foods. It is important to avoid fatty or greasy foods, as well as foods that are high in fiber, as these can be harder for the digestive system to handle after the surgery. Following the recommended diet plan can help ensure proper healing and reduce the risk of complications.

Suitable For

Patients who are typically recommended for a Whipple procedure include those with:

  1. Pancreatic cancer: The Whipple procedure is commonly used to treat pancreatic cancer, particularly tumors located in the head of the pancreas.

  2. Ampullary cancer: This type of cancer affects the ampulla of Vater, which is where the common bile duct and pancreatic duct meet and empty into the small intestine. The Whipple procedure can be used to remove tumors in this area.

  3. Distal bile duct cancer: Tumors located in the bile duct close to the liver can also be treated with a Whipple procedure.

  4. Chronic pancreatitis: In some cases of chronic pancreatitis that cannot be managed with other treatments, a Whipple procedure may be recommended to alleviate symptoms and improve quality of life.

  5. Neuroendocrine tumors: Some types of neuroendocrine tumors, such as gastrinomas or insulinomas, may require a Whipple procedure for removal.

It’s important for patients to undergo a thorough evaluation by a multidisciplinary team of specialists to determine if they are suitable candidates for a Whipple procedure. Factors such as the size and location of the tumor, overall health and fitness of the patient, and potential risks and benefits of the surgery will all be taken into consideration when making this decision.

Timeline

Before the Whipple procedure:

  • Patient undergoes various tests and evaluations to determine the need for surgery and assess overall health
  • Patient meets with the surgical team to discuss the procedure, potential risks, and expected outcomes
  • Patient may need to follow a special diet or take medications to prepare for surgery
  • Patient may need to stop taking certain medications or supplements before surgery
  • Patient may need to undergo additional imaging tests or procedures to plan for surgery

After the Whipple procedure:

  • Patient is closely monitored in the hospital for complications or signs of infection
  • Patient may experience pain, nausea, and fatigue in the days following surgery
  • Patient gradually begins to resume eating and drinking, starting with clear liquids and then progressing to solid foods
  • Patient may need to take pain medications or other medications as prescribed by the surgical team
  • Patient may need to follow a special diet or make changes to their lifestyle to support recovery
  • Patient attends follow-up appointments with the surgical team to monitor recovery, address any concerns, and discuss long-term care and surveillance for potential cancer recurrence.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the Whipple procedure?

  2. How long is the recovery period after the Whipple procedure, and what can I expect during that time?

  3. Will I need any additional treatments, such as chemotherapy or radiation therapy, after the Whipple procedure?

  4. How will the Whipple procedure affect my digestion and nutritional intake in the long term?

  5. What are the chances of the cancer returning after the Whipple procedure?

  6. How experienced is the surgical team in performing the Whipple procedure, and what is the success rate of this surgery at this facility?

  7. Are there any alternative treatment options to the Whipple procedure that I should consider?

  8. How will the Whipple procedure impact my quality of life, including daily activities, diet, and overall health?

  9. What follow-up appointments and monitoring will be necessary after the Whipple procedure?

  10. Are there any lifestyle changes or precautions I should take before and after the Whipple procedure to optimize my recovery and long-term outcomes?

Reference

Authors: Dapri G, Bascombe NA, Gerard L, Samaniego Ballart C, Gimenez Viñas C, Saussez S. Journal: Ann Surg Oncol. 2017 Sep;24(9):2785-2786. doi: 10.1245/s10434-017-5944-x. Epub 2017 Jun 26. PMID: 28653162