Hepato-pancreato-biliary: Pancreaticoduodenectomy (Whipple Procedure)
Whipple procedure, also known as a pancreaticoduodenectomy, is an operation to remove the head of the pancreas, the first part of the intestine(duodenum), the gallbladder and the bile duct. It is performed to treat pancreatic cancer and other disorders of the pancreas, intestine and bile duct.
Risks and possible complications of the operation:
- Bleeding
- Infection, at the level of the wound, intra-abdominal or bloodstream
- Pain
- Risks of anesthesia
- Delayed emptying of stomach, which results in nausea, vomiting, delaying oral intake, and may require prolonged use of a nasogastric tube
- Leakage from the pancreas (pancreatic fistula)
- Leakage from the bile duct
- Stricture (narrowing) of the bile duct
- Pancreatitis
- Diabetes
- Exocrine insufficiency due to loss of pancreatic enzymes (inability to absorb fat and nutrients causing diarrhea; may require you to take pancreatic enzymes with your meals
- Blood clot forming in your legs and lungs
- Cardiopulmonary event, pneumonia, heart attack
- Death
- Discuss with your surgeon your use of blood thinning medications such as Warfarin, Lovenox, Heparin, Pradaxa, Xarelto, Eliquis, ASA, Plavix, and other anticoagulants/antiplatelets.
- Exercise daily prior to surgery. Exercising will help your body get into its best condition for your surgery and make your recovery faster and easier.
- Do not wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
- If you are a smoker, stopping smoking 4wks before surgery is strongly recommended to lower the risk for lung and wound complications.
- Shower with an antimicrobial soap the evening before and the morning of surgery. Please, do not shave the surgical area 48 hours prior to surgery.
- The day before your surgery, you may eat a regular diet. Starting midnight, you may only drink clear liquids( sports drinks, tea, coffee without creamer or milk, apple juice, water, clear broth, popsicles). You can continue with a clear liquid diet until 2 hours prior to your surgery.
- 1-7 days prior to your scheduled surgery, pre-anesthesia clinic will call you to review your medical history and medications as well as review pre-operative instructions. Preanesthesia clinic number: 520-694-4232
- A surgery scheduler will call to confirm your surgery and arrival times by calling your phone number on file between 2 p.m. and 4 p.m. the day prior to surgery. (For Monday surgeries, you will receive a call on Friday). Please, make sure to answer the call and check your voicemail. Scheduler number: 520-694-2873
- The morning of surgery, you will check in at the admission desk on the first floor and register. They will send you up to the preoperative waiting room on the third floor once you are registered.
- Nurses and staff members will confirm your name, date of birth, procedure, and surgeon. This will be done multiple times by multiple people during your stay to ensure your safety.
- You will then need to change into a surgical gown.
- Before surgery an IV line is put into a vein usually in your arm. This is used to inject fluids and medications into your veins as needed.
- While you are asleep, additional IV lines may be placed.
- While asleep we will insert a urinary catheter into your bladder. A nasogastric tube will also be placed extending from your nose into your stomach. Both of these tubes will be present when you awake.
- Upon completion of the operation, your surgeon will place 1-2 drains into the abdominal cavity which will extend out through the skin and remain in place for the next few days. There are times when you need to go home with the drain in place. If this is the case, you will be shown how to care for it.
- The anesthesia team will block the nerves around your incision before you wake up to help with pain control after surgery.