Whipple Operation in Singapore

The Whipple procedure (also known as pancreaticoduodenectomy) is a surgical procedure used by doctors to treat patients diagnosed with pancreatic cancer. This procedure is also performed for patients with certain benign pancreatic disorders, including chronic pancreatitis.

The Whipple procedure (or Whipple resection) involves the removal of the head of the pancreas, part of the duodenum; which is the uppermost portion of the small intestine, a small portion of the stomach called pylorus, the gallbladder, and the lymph nodes near the head of the pancreas.

Multiple clinical studies have shown that the Whipple procedure has better survival rates for patients diagnosed with pancreatic cancer compared to chemotherapy or radiotherapy alone. It is potentially a curative option for patients with pancreatic cancer. However, not all patients are suitable for the Whipple procedure.

How Is the Whipple Procedure Performed?

The Whipple operation starts with the removal of not only the pancreas head, but also parts of the small intestine, gallbladder, bile duct, and part of the stomach. Next, the pancreas cancer surgeon reattaches all the remaining parts of the pancreas and digestive organs, in order to facilitate recovery of normal activity of the digestive system.

The Whipple operation may be done traditionally (open) or laparoscopically, depending on several factors, such as the extent of disease, and the overall health condition of the patient.

Open Whipple Procedure For a standard, open Whipple procedures, a vertical or transverse incision is made on the abdomen, and the abdominal cavity is first checked thoroughly for signs of metastasis. If the cancer has spread to other abdominal organs or invaded major vessels, the patient may be referred to a liver cancer surgeon for further evaluation.

But if no other organs are affected, the Whipple surgeon will then proceed to remove the head of the pancreas, the first part of the small intestine (duodenum), the lower part of the stomach, gallbladder, and bile duct. Typically, the surrounding lymph nodes will be removed for adequate staging of the disease. Certain cases may require vascular reconstruction of major vessels if the tumour is close to the blood vessels or if the tumour has invaded the blood vessels.

After the removal of the pancreatic tumour, reconstruction will be required. This involves reconnection of the remaining parts of the stomach, pancreas, and intestines to facilitate digestive processes.

Laparoscopic Whipple Operation Laparoscopic Whipple operation may be offered to some individuals, where the organs are accessed and removed through several small incisions in the abdomen with the help of a monitor and a light-and-camera-assisted scope.

Compared to traditional open surgery, this method results in smaller incisions and less wound pain. It takes several hours to perform, which is similar to an open Whipple operation.

Modified Whipple Surgery The modified Whipple surgery is an alternative approach that preserves more of the stomach and surrounding tissues compared to the standard Whipple procedure.

The main advantage of this surgery is a quicker recovery time due to the preservation of the stomach and pylorus (the valve that controls food passage from the stomach to the small intestine). This allows for better digestive function post-surgery.

What to Expect After a Whipple Surgery?

After the Whipple surgery, patients will typically be admitted to the high dependency (HD) or intensive care unit (ICU) overnight and will stay in the hospital for a week or two for further observation and monitoring of progress. As patients gradually recover, they will be advised to take liquids and small meals.

After 1 to 2 weeks, most patients are able to take food quite normally. Typically, most patients will be advised to take smaller amounts and more frequent meals in the initial few weeks of their recovery after the Whipple operation. Pain control is important for post-surgery recovery and is usually accomplished with epidural anaesthesia or patient-controlled analgesia.

Most patients are able to sit out of bed after the first 1-2 days of surgery. There are some monitoring tubes and drains which will be progressively removed once not needed, as patients recover in the ward. Full recovery takes approximately a month for patients to get back to work.

Who May Undergo Whipple Procedure?

As the pancreas is surrounded by many vital organs and a network of blood vessels, pancreatic cancer rapidly spreads to other organs and tissues of the pancreas itself. When this occurs, it is difficult to perform the Whipple procedure for curative intent. For this reason, not all pancreatic cancer patients are eligible to undergo the Whipple procedure. It is mainly intended to help patients with cancer limited to the head of the pancreas only.

Are There Any Complications Associated with Whipple Surgery?

As in any surgical procedure, complications may occur.

Below is a list of complications associated with the Whipple procedure:

Bleeding
Pancreatic fistula with leakage from the pancreas
Wound infection or delayed wound healing
Impaired sugar control or diabetes as a consequence of removal of the pancreatic head
Wound pain
Weight loss after the procedure (most patients will lose 10-15% of their current weight)
Digestive disorders, such as diarrhoea, improper digestion, and delayed bowel movements

Explore your treatment options for pancreatic cancer.

If you have recently been diagnosed with pancreatic cancer, it is essential to consult with a specialist on treatment options, such as Whipple procedure. At our liver clinic, we provide modern care in hepatobiliary and pancreatic surgery tailored to your needs. Contact us today at 6737 8878 or send us a message for a comprehensive assessment.

Enquire Now