Pancreaticoduodenectomy Surgery

Pancreaticoduodenectomy is a procedure commonly used to remove pancreatic cancers. This procedure may also help treat conditions, such as cysts and cancers in the bile ducts and the beginning part of the small intestine (duodenum). Although recovery from pancreaticoduodenectomy can be challenging, it is primarily recommended for controlling tumors in the head of the pancreas and offers a significant opportunity for long-term control if the cancer has not spread extensively.

What Is a Pancreaticoduodenectomy?

The pancreas is a glandular organ about six inches long that is shaped like a thin pear. It is located between the stomach and the spine. The wider end of the pancreas is called the head, the middle section is called the body, and the narrow end is called the tail. The pancreas is surrounded by the stomach, small intestine and other organs, such as the liver, spleen and gallbladder.

Its two main functions include digestion and blood sugar regulation. The pancreas produces juices, which contain enzymes that help break down food into substances the body can use, and several hormones, including insulin and glucagon, help control blood sugar levels and help the body use and store energy from food.

Pancreatic cancer develops when abnormal cells in the pancreas multiply uncontrollably, forming a tumor. Its symptoms are often nonspecific, resembling those of other conditions, and may not manifest in the early stages. Early diagnosis is challenging. As the cancer progresses, symptoms may include:

• Jaundice (yellowing of the skin and eyes)
• Light-colored stools
• Dark urine
• Abdominal and back pain
• Unexplained weight loss
• Loss of appetite
• Fatigue

Pancreatic cancer is associated with various risk factors that do not directly cause the disease but increase the likelihood of developing it. These risk factors contribute to DNA damage within pancreatic cells, which may lead to the formation of cancer. It is important to note that having these risk factors does not guarantee that you will develop the condition. Some people with risk factors never get pancreatic cancer, while others without known risk factors do.

Risk factors for pancreatic cancer include:

• Smoking
• Carrying excess body weight
• Having a personal history of diabetes or chronic pancreatitis
• Having a family history of pancreatic cancer or pancreatitis
• Having certain hereditary conditions, such as:
  • Multiple endocrine neoplasia type 1 (MEN 1) syndrome
  • Hereditary nonpolyposis colon cancer (HNPCC; Lynch syndrome)
  • Von Hippel-Lindau syndrome
  • Peutz-Jeghers syndrome
  • Hereditary breast and ovarian cancer syndrome
  • Familial atypical multiple mole melanoma (FAMMM) syndrome
  • Ataxia-telangiectasia

Talk to your doctor and genetic counselor if you think you are at risk of developing pancreatic cancer so they can give you information and help determine if you should get genetic testing for inherited cancer risk.
Standard treatments for pancreatic cancer include surgery, chemotherapy, radiation or a combination of these approaches. Pancreaticoduodenectomy, commonly known as the Whipple procedure, is an extensive surgery that aims to remove pancreatic tumors that have not spread beyond the pancreas and can be resected or removed surgically. A significant portion of the gastrointestinal tract is removed and reconstructed during a Whipple procedure.

How Long Is a Whipple Surgery?

The procedure usually takes five to seven hours.

What Procedure Is Considered a Pancreaticoduodenectomy?

During a standard pancreaticoduodenectomy or Whipple procedure, the surgeon removes the head of the pancreas, the gallbladder, the duodenum, a portion of the stomach and surrounding lymph nodes. Enough of the pancreas is left intact to continue producing digestive juices and insulin. The remaining pancreas and digestive organs are then reconnected. In some cases, patients may undergo a modified version of the Whipple procedure known as pylorus-preserving Whipple, where the entire stomach and the stomach valve (pylorus) are retained.

Why Do a Pancreaticoduodenectomy?

While pancreaticoduodenectomy has a high risk of complications, pancreatic cancer is usually aggressive with a poor outlook. The Whipple procedure can be lifesaving as it removes the cancerous parts of the pancreas while preserving digestive function and insulin production. Additionally, it is an effective way to prevent the spread of pancreatic cancer to other organs. For eligible patients, surgery is the best option for long-term survival from pancreatic cancer.

Find a General Surgeon in Nacogdoches

Healthcare is better together. If you are experiencing pain or discomfort related to pancreatic disease, have been recently diagnosed, or know someone who has, the Nacogdoches Medical Partners can help. Our dedicated team can determine a suitable surgical approach for treating pancreatic problems.

To schedule a complimentary consultation today, call 936-221-5560 or request an appointment online.

Takeaways

Various treatment options are available for pancreatic cancer. It is essential to work with your cancer care team to help create a personalized plan that considers factors such as cancer stage, overall health and preferences. The plan should outline the treatment goals, options, potential side effects and expected duration. It would be helpful to discuss expectations with your cancer care team before surgery to gain valuable insights into preparation, experiences and necessary support.