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What is pancreaticoduodenectomy?
When the duodenum is removed along with all or part of the pancreas, the procedure is called a pancreaticoduodenectomy, which surgeons sometimes refer to as "Whipple's procedure."
What is a common complication from a pancreaticoduodenectomy?
One of the most common complications from a pancreaticoduodenectomy is delayed gastric emptying, a condition in which food and liquids are slow to leave the stomach.
What disease does a pancreaticoduodenectomy treat?
Pancreaticoduodenectomies are increasingly used to treat a variety of malignant and benign diseases of the pancreas.
What nodes are sometimes removed during a pancreaticoduodenectomy?
This procedure often involves removal of the regional lymph nodes as well.
How many pancreaticoduodenectomy patients develop the complication known as delayed gastric emptying?
This complication occurred in 19% of patients in the Johns Hopkins study.
What are the chances for recurrence of a cancerous tumor following a pancreatectomy?
The risk for tumor recurrence is thought to be unaffected by whether the patient undergoes a total pancreatectomy or a pancreaticoduodenectomy.
What organ does a whipple surgery work on?
Whipple surgery works on the pancreas and duodenum, and is an operation used to treat cancerous tumors. It's official name is a pancreaticoduodenectomy, but it is commonly known as the Whipple procedure after the American surgeon Allen Whipple who refined the technique in the 1930's.
Pancreatic carcinoma?
DefinitionPancreatic carcinoma is cancer of the pancreas.Alternative NamesPancreatic cancer; Cancer - pancreasCauses, incidence, and risk factorsThe pancreas is a large organ that is found behind the stomach. It makes and releases enzymes that help the body absorb foods, especially fats. Hormones called insulin and glucagon are also made in the pancreas. These hormones help your body control blood sugar levels.The exact cause is unknown, but pancreatic cancer is more common in smokers and people who are obese. Pancreatic cancer is slightly more common in women than in men. The risk increases with age.A small number of cases are related to genetic syndromes that are passed down through families.SymptomsA tumor or cancer in the pancreas may often grow without any symptoms at first. This may mean pancreatic cancer is more advanced when it is first found.Early symptoms of pancreatic cancer include:Pain or discomfort in the upper part of the belly or abdomenLoss of appetite and weight lossJaundice (a yellow color in the skin, mucus membranes, or the eyes)Dark urine and clay-colored stoolsFatigue and weaknessNausea and vomitingOther possible symptoms are:Back painBlood clotsDepressionDiarrheaDifficulty sleepingIndigestionSigns and testsCT scan of the abdomenMRI of the abdomenEndoscopic retrograde cholangiopancreatography (ERCP)EndoscopicultrasoundPancreatic biopsyThis disease may also affect the results of the following tests:Liver function testsSerum bilirubinComplete blood count (CBC)TreatmentBecause pancreatic cancer is often advanced when it is first found, very few pancreatic tumors can be removed by surgery. The standard procedure is called a pancreaticoduodenectomy (Whipple procedure).This surgery should be done at centers that perform the procedure frequently. Some studies suggest that surgery is best performed at hospitals that do more than five of these surgeries per year.When the tumor has not spread out of the pancreas but cannot be removed, radiation therapy and chemotherapy together may be recommended.When the tumor has spread (metastasized) to other organs such as the liver, chemotherapy alone is usually used. The standard chemotherapy drug is gemcitabine, but other drugs may be used. Gemcitabine can help approximately 25% of patients.Patients whose tumor cannot be totally removed, but who have a blockage of the tubes that transport bile (biliary obstruction) must have that blockage relieved. There are generally two approaches to this:SurgeryPlacement of a tiny metal tube (biliary stent) during ERCPManagement of pain and other symptoms is an important part of treating advanced pancreatic cancer. Hospice can help with pain and symptom management, and provide psychological support for patients and their families during the illness.Support GroupsYou can ease the stress of illness by joining a support group with members who share common experiences and problems (see cancer - support group).Expectations (prognosis)Some patients with pancreatic cancer that can be surgically removed are cured. However, in more than 80% of patients the tumor has already spread and cannot be completely removed at the time of diagnosis.Chemotherapy and radiation are often given after surgery to increase the cure rate (this is called adjuvant therapy). For pancreatic cancer that cannot be removed completely with surgery, or cancer that has spread beyond the pancreas, a cure is not possible and the average survival is usually less than 1 year. Such patients should consider enrolling in a clinical trial (a medical research study to determine the best treatment).Ninety-five percent of the people diagnosed with this cancer will not be alive 5 years later.ComplicationsBlood clotsDepressionInfectionsLiver problemsPainWeight lossCalling your health care providerCall for an appointment with your health care provider if you have:Back painUnexplained fatigue or weight lossLoss of appetitePersistent abdominal painOther symptoms of this disorderPreventionIf you smoke, stop smoking.Eat a diet high in fruits, vegetables, and whole grains.Exercise regularly.ReferencesNational Cancer Institute. Pancreatic cancer treatment PDQ. Updated July 31, 2008.Tempero M, Brand R. Pancreatic cancer. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 204.
How do you get pancreatic cancer?
Pancreatic CancerMost pancreatic tumors originate in the duct cells or in the cells that produce digestive enzymes (acinar cells). These tumors account for nearly 95 percent of pancreatic cancers. When these cells are healthy, they grow and divide in an orderly way. When DNA is damaged in these cells by certain things, cells may begin to grow out of control and eventually form a tumor. What damages DNA in the majority of cases of pancreatic cancer is unknown, but a small percentage of people develop the disease as a result of a genetic predisposition. These people who have a close relative, such as a parent or sibling, with pancreatic cancer have a higher risk of developing pancreatic cancer themselves. Development of other genetic diseases have been associated with an increased risk of pancreatic cancer, including familial adenomatous polyposis, nonpolyposis colon cancer, familial breast cancer associated with the BRCA2 gene, and hereditary pancreatitis. Only about 10 percent of pancreatic cancers result from an inherited tendency. A greater number are caused by environmental or lifestyle factors, such as smoking, diet and chemical exposure. Smokers are two to three times more likely to develop pancreatic cancer than nonsmokers are. This is probably the greatest known risk factor for pancreatic cancer, with smoking associated with almost one in three cases of pancreatic cancer. A diet high in animal fat and low in fruits and vegetables may increase your risk of pancreatic cancer as well.People who work with petroleum compounds, including gasoline and other chemicals, have a higher incidence of pancreatic cancer than people not exposed to these chemicals on a regular basis. Resent research has also shown that chronic, advanced gum disease seem to be associated with development of pancreatic cancer, but by some unknown mechanism.
