HPB Surgery › Whipple's Procedure
Whipple's Procedure
Pancreaticoduodenectomy — the gold standard operation for cancers of the pancreatic head, bile duct and duodenum.
Overview
What is a Whipple's Procedure?
The Whipple's procedure (pancreaticoduodenectomy) is one of the most complex operations in abdominal surgery. It involves the removal of the head of the pancreas, the duodenum, the gallbladder, and part of the bile duct, followed by intricate reconstruction of the digestive and biliary systems. It is the primary surgical treatment for cancers of the pancreatic head, distal bile duct, ampulla of Vater, and duodenum.
Specialist Expertise Required
Whipple's procedure should be performed by a specialist HPB surgeon at a high-volume centre. Dr. Nahm has performed this operation extensively at Westmead Hospital and during his fellowship at St. James's University Hospital, Leeds.
Indications for Whipple's Procedure
- Pancreatic ductal adenocarcinoma (head of pancreas)
- Ampullary carcinoma
- Distal cholangiocarcinoma (bile duct cancer)
- Duodenal adenocarcinoma
- Chronic pancreatitis with obstruction
- Certain benign tumours of the pancreatic head
The Operation
The procedure involves removing the head of the pancreas together with the duodenum, distal bile duct, and gallbladder. The digestive tract is then reconstructed with three connections (anastomoses): the pancreas to the small bowel (pancreaticojejunostomy), the bile duct to the small bowel (hepaticojejunostomy), and the stomach to the small bowel (gastrojejunostomy).
The operation typically takes 5–8 hours and requires a hospital stay of 7–14 days. Dr. Nahm performs this operation at Westmead Hospital, a major tertiary referral centre.
Recovery
Recovery from a Whipple's procedure involves a period of careful in-hospital monitoring followed by gradual return to normal activities over 6–12 weeks. Most patients will require adjuvant chemotherapy following surgery, and this is coordinated with the oncology team.