Our Summary

This research paper talks about a 14-year experience handling severe injuries to the pancreas or duodenum (parts of the digestive system) at a major trauma center. Such injuries are quite serious and sometimes require a complex surgery called the Whipple procedure.

The study looked back at patients over the age of 15 who had these severe injuries and needed the Whipple procedure. They divided the patients into two groups: those who had the surgery right away and those who were considered for the surgery but either had it later, died before they could have it, or had a different procedure instead.

Out of over 66,000 trauma patients during the study period, 666 had injuries to the pancreas or duodenum, and 20 of these were severe enough to meet the study’s criteria. Of these, 6 had the Whipple procedure right away and 14 were considered for it. The majority of patients were young males, mostly Black, and the injuries were mostly due to gunshot wounds. All the patients had at least one other injury as well, most often to major blood vessels, the colon, or the liver.

The study found that these types of injuries that require the Whipple procedure are rare but can be deadly, usually due to heavy bleeding within the first 24 hours. About half had a type of surgery that controls damage and then had the Whipple procedure later. However, having the Whipple procedure right away can be done in some patients, depending on how severe the injury is, the patient’s physical condition, and how well they can be resuscitated.

FAQs

  1. What is the Whipple procedure and when is it required?
  2. How many patients in the study had injuries severe enough to require the Whipple procedure?
  3. What factors determine whether a patient should have the Whipple procedure right away or later?

Doctor’s Tip

A doctor might tell a patient who is undergoing a Whipple procedure to expect a longer recovery time compared to other surgeries. It is important to follow post-operative instructions carefully, including taking pain medication as prescribed, eating a specialized diet, and attending follow-up appointments. It is also important to communicate any concerns or changes in symptoms to your healthcare team. Remember to be patient with yourself during the recovery process, as it may take several weeks or even months to fully regain strength and function.

Suitable For

Patients who are typically recommended for the Whipple procedure are those who have severe injuries to the pancreas or duodenum, often as a result of trauma such as gunshot wounds. These patients may also have injuries to other organs, such as major blood vessels, the colon, or the liver. The decision to perform the Whipple procedure may depend on factors such as the severity of the injury, the patient’s overall health and physical condition, and the ability to control bleeding and stabilize the patient. In some cases, the Whipple procedure may be done right away, while in others it may be delayed until the patient is more stable.

Timeline

Before the Whipple procedure:

  • Patient experiences a severe injury to the pancreas or duodenum, often due to trauma such as gunshot wounds
  • Patient may have other injuries to major blood vessels, colon, or liver
  • Patient is evaluated for the need for the Whipple procedure based on the severity of the injury, physical condition, and ability to be resuscitated

After the Whipple procedure:

  • Patient undergoes the complex surgery, which involves removing part of the pancreas, duodenum, and other nearby organs
  • Recovery period typically involves several days in the hospital, monitoring for complications such as infections or leaks
  • Patient may require a modified diet and lifestyle changes to manage digestion and prevent complications
  • Long-term follow-up care is needed to monitor for potential complications and ensure proper healing and function of the digestive system

What to Ask Your Doctor

Some questions a patient should ask their doctor about the Whipple procedure include:

  1. What is the purpose of the Whipple procedure in my specific case?
  2. What are the risks and potential complications associated with the Whipple procedure?
  3. How experienced are you in performing the Whipple procedure?
  4. What is the expected outcome of the Whipple procedure for me?
  5. What is the recovery process like after the Whipple procedure?
  6. Will I need any additional treatments or therapies following the Whipple procedure?
  7. Are there any specific dietary or lifestyle changes I need to make after the Whipple procedure?
  8. How long will I need to stay in the hospital after the Whipple procedure?
  9. What support services are available to help me during my recovery from the Whipple procedure?
  10. Are there any long-term effects or considerations I should be aware of after the Whipple procedure?

Reference

Authors: Noorbakhsh S, Wagner V, Arientyl V, Orlin S, Koganti D, Fransman RB, Bishop ES, Castater CA, Nguyen J, De Leon Castro A, Davis MA, Smith RN, Todd SR, Sciarretta JD. Journal: Injury. 2024 Sep;55(9):111721. doi: 10.1016/j.injury.2024.111721. Epub 2024 Jul 20. PMID: 39084919