Shaymaa Abed Saadoon, 39, hailing from Baghdad, Iraq was diagnosed to have cancer head of the pancreas. At Iraq, she was planned for Whipple procedure; however, at surgery, the tumour was found to be involving adjacent major blood vessels (SMV). Hence cancer could not be removed, and double bypass operation was performed. Determined to fight her disease, she came to Max Hospital in Delhi in October 2018. CT angiography of the abdomen displayed a large tumour involving adjacent major blood vessel, i.e. superior mesenteric vein (SMV) the main vessels that drain blood from small & large intestine. The patient was advised the Whipple Procedure. The surgery was challenging because of dense adhesions due to previous double bypass surgery and loss of tissue planes with major blood vessels (IVC, SMA & SMV) due to radiotherapy; however, no vascular resection was required. The postoperative period was uneventful, and she was discharged on the seventh postoperative day.
What Is Whipple's Procedure
Whipple's procedure is a surgical process of removing the head of the pancreas, the duodenum, the gallbladder and the part of the bile duct. The remaining organs are reattached to enable the patient to digest food normally post-surgery. Dr Dinesh Singhal, Senior Director & HOD and Dr Nitin Vashistha, Senior Consultant, Surgical Gastroenterology, Max Super Speciality Hospital, Saket says, “Whipple’s procedure is technically one of the most demanding abdominal operations. In this case, previous surgery and subsequent radiotherapy added substantially to the complexity and risks of the procedure. The final biopsy report suggesting that 'all margins were free of tumour' was particularly gratifying. This innovative treatment offers new hope for patients with locally advanced pancreatic head cancers that were earlier deemed inoperable.”
Why Is It Done?
This procedure is done in those cases where the pancreas, duodenum or bile duct has some cancerous growth or any disorder. Pancreases are a vital organ to carry bile in the body. They also secrete an enzyme, which is highly beneficial for proper food digestion, especially for fat and protein in the body. Located in the upper abdomen, pancreas is also essential to manage the blood sugar level in the body. Whipple procedure is suggested to patients with the following disorders and health conditions:
- Tumours in pancreas
- Pancreatic cancer
- Cysts in pancreas
- Cancer in the bile duct
- Bowel cancer
- Trauma in the pancreas or small intestine
- Other cancers in the stomach
Whipple procedure is done to remove the cancerous growth in the pancreas and further limit it from spreading in the body. This treatment also ensures a high survival rate in such complex cancer treatments.
Precautions Before And After The Surgery
Food And Medication
Consult your doctor for the medications that you are taking and its frequency while the surgery is planned. It is essential to prepare your body for the surgery with a suitable diet. Get a detailed diet chart from the doctor on what can be eaten and what not to ensure a successful operation.
In most cases, the patient might be told to stay in the hospital for 1-2 weeks for regular checkups. In some cases, the person undergone surgery may experience bowel paralysis and will be put on a feeding tube to fulfil the nutritional needs of the body. While recovering from the surgery, the following care should be taken:
- Eat small portions of meals at a time. Rather than three meals a day, have 4-5 meals a day of less quantity.
- Avoid fried and processed food. Eat home-cooked meals, which are light on the stomach and easy to digest.
- Drink lots of fluids to support the healing of the body.
- Do not indulge in strenuous physical activities for a few weeks after the surgery.
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