Pancreatic Surgery
Pancreaticoduodenectomy (Whipple Procedure):
This procedure is performed for cancer of the pancreatic head and
ampulla.
A pancreaticoduodenectomy, also known as a Whipple procedure, involves
the removal of the pancreas head due to a tumor in the pancreas or bile
duct, or pancreatitis. If a tumor exists in the head of the pancreas, it
is usually necessary to remove the pancreatic head, duodenum,
gall-bladder and a portion of the bile duct .Sometimes, part of the
stomach is also removed. The end of a patients bile duct and the
remaining pancreas are then connected to the small bowel to ensure flow
of bile and enzymes into the intestines.
Distal Pancreatectomy (laparoscopic or open):
Indicated for tumors in the body and tail of the pancreas, a distal
pancreatectomy involves the removal of neoplasms either laparoscopically
or with open surgery. With both laparoscopic and open distal
pancreatectomy procedures, surgeons attempt to preserve the spleen.
Drainage Procedures
- With chronic pancreatitis, a dilated pancreatic duct usually
reflects obstruction. Quite often these patients present with stones
in the pancreas.
Procedures to improve ductal drainage include:
Longitudinal Pancreaticojejunostomy (Puestow Procedure):
The pancreatic duct is opened from the tail to the head of the pancreas and attached to the small bowel.
Sphincteroplasty:
When endoscopic sphincterotomy is unsuccessful, surgical
sphincteroplasty may be required of the minor or major papilla.