Whipple Procedure

Overview: The Best Surgeon for Whipple Procedure

djt whipple 1 1024x1013The Whipple procedure is a type of HPB Surgery & Oncology treatment that is recommended for advanced pancreatic cancer that has spread to the small intestines, gallbladder, and bile ducts. This procedure is also known as pancreaticoduodenectomy. It involves removing the head of the pancreas, the duodenum, the distal bile duct, and the gallbladder. This procedure is performed when the tumor is located in the head of the pancreas. In the late stages of pancreatic cancer, the gallbladder, bile duct, and the first part of the small intestines become affected by the disease as well.

The Whipple procedure is done to prevent the further spread of cancer by removing all of the diseased tissue. The specialized Whipple surgeon  removes the gallbladder, bile duct, and the head of the small intestines (duodenum) and then reconnects the remaining organs. One of the best surgeons for Whipple procedure surgery, like Dr. Tierney, perform this procedure through both open and robotic approaches.

Related Procedures

Total Pancreatectomy

This procedure removes the whole pancreas together with the small intestines, gallbladder, and spleen. It is possible to live without the pancreas but one must depend on a lifetime of insulin shots and oral enzymes.

ENDOSCOPIC RETROGRADE CHOLAGIOPANCRE-ATOGRAPH (ERCP)

This procedure is typically the first intervention for the treatment of chronic pancreatitis. Through ERCP obstructing stones in the pancreatic duct can be removed and narrowed areas in the pancreatic duct (strictures) can be stented. Some patients do not respond or only temporarily respond to ERCP, at which point they are considered for surgery.

Frey procedure

This procedure is good for patients who have severe inflammation in the head of the pancreas with associated dilation of the main pancreatic duct. It involves a top surgeon for Whipple procedure coreing out the tissue in the head of the pancreas and opening the main pancreatic duct along the length of the gland then sewing a piece of intestine over the cored-out region and the duct to improve drainage.

PEUSTOW PROCEDURE

When the main pancreatic duct is dilated more than 6mm, this procedure is performed. It involves opening the pancreatic duct over the length of the gland and suturing a piece of intestine to the duct so that it drains properly. This procedure can be very successful in select patients and can be performed robotically in a minimally invasive fashion by a top Whipple surgeon.

DISTAL PANCREATECTOMY WITH/WITHOUT SPLENECTOMY

This procedure is performed in cases where the disease is located in the body or tail of the pancreas. It involves the removal of that portion of the gland. The decision to remove the spleen is made based on whether or not the splenic vein has a clot in it. If the splenic vein is clotted due to the chronic inflammation in that region the spleen will be removed to prevent gastrointestinal bleeding in the future. This procedure can often be performed robotically by a top surgeon for Whipple procedure so the recovery is short.

Before surgery

The steps followed before surgery are:

  • An office visit for surgical consultation where a comprehensive history and physical exam is performed.
  • Completion of clinical tests for workup and staging.

  • Multidisciplinary tumor board review for an expert recommendation regarding treatment strategy.

After surgery

The type of surgical procedure done determines the kind of 

post-surgery care 

required. Post care after a surgical operation involves:

  • A brief admission to the ICU is sometimes required for complex procedures such as a whipple procedure. Recovery then continues in the hospital ward for another three to five days. Procedures performed robotically typically have a faster recovery and can expect discharge from the hospital one or two days earlier than after open procedures. 

  • The goals of postoperative care include: monitoring for and intervening on any complications that can occur, awaiting the resumption of normal bowel function, maintaining adequate hydration and nutrition, physical and occupational rehabilitation, and providing adequate pain control. Once these measures are met, the patient will be discharged from the hospital. Post-operative follow-up will be scheduled one week from discharge with Dr. Tierney.

Why should you choose Dr. Tierney for the Whipple Procedure?
joshua tierney 1
Why should you choose Dr. Tierney for the Whipple Procedure?
Dr. Joshua S. Tierney, MD is a fellowship-trained Hepatopancreatobiliary (HPB) surgeon with a wide breadth of experience in complex pancreatic surgery. In addition, he is one of the few surgeons in the country who performs robotic Hepatopancreatiobiliary (HPB) surgery. He believes in a multidisciplinary team approach that requires personalized attention and extensive consultation with other medical professionals to develop a treatment plan that is on the cutting edge of cancer care.

Dr. Tierney received a Bachelor of Science Degree from Purdue University in 2006, a Doctor of Medicine Degree from the Indiana University School of Medicine in 2011, completed his residency in General Surgery at Vanderbilt University, and completed his Hepatopancreatiobiliary (HPB) and Therapeutic Endoscopy Fellowship at the University of Louisville.

Do you have a medical concern that would require Dr. Tierney’s attention? Schedule an appointment by calling 970-221-5878.
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