What is Whipple surgery & its indications? - Dr. Nanda Rajaneesh скачать в хорошем качестве

What is Whipple surgery & its indications? - Dr. Nanda Rajaneesh

Whipple’s surgery is a surgery that we do on the pancreas, for pancreatic cancers. For that we should know the anatomy of the pancreas. The pancreas sits on very big blood vessels called as aorta and it connects into the intestine directly into the duodenum, and there is another structure next to that called as the tract that comes from the liver. So the Whipple is considered as a very big surgery as we remove the tumor from the pancreas, we remove the tumor from the pancreas, we also remove part of the pancreas along with lot of lymphatics around it and these has to come out from the surface of large blood vessels over there and also when we do a whipple, we also remove apart from the pancreas, also the duodenum and the attachment of the duodenum. Let us say it is the bile duct, that is the common bile duct, or the pancreatic duct, that is also disconnected, and if it is the duodenal, one side attachments to the liver, one side attachments to the stomach. All this have to be reconnected. This reconnection is an extensive procedure and if we reconnect the ducts and the lumens of the intestine, then what happen is these reconstructions can leak. That is why thus is considered to be a surgery and secondly when we do a whipple’s surgery in a complicated cases, where the tumor is infiltrating or touching the surface of large blood vessels like the portal vein, then there can be infiltration of the tumor on that surface. So we have to be very careful in removing the tumor from the surface of the portal vessels because there is intraoperative bleeding, there we will have to be repaired for it once. Secondly if there is a need, should we reject the portal vein to give a zero clearance of the tumor. That is why the surgery is considered to be a very big surgery.