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 patient’s 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.