Today, pancreatic cancer is a common type of cancer. In most cases, the prognosis has pretty bad consequences. During the examination, doctors detect the presence of secondary metastases that affect healthy tissues of other organs.
The main disadvantage of this disease is that there are no symptoms of the disease. At the same time, cancer cells begin to grow with great force. If a large number of metastases are detected, patients do not undergo surgical manipulations.
Pancreatoduodenal resection technology
To whom can pancreatoduodenal resection be recommended? Surgical intervention is indicated only for those patients in whom the cancerous tumors have a clear localization within the pancreas. Such surgery acts as a treatment process.
Before the operation, the attending physician conducts a complete diagnosis of the affected organ. Thanks to an ultrasound examination and many analyzes, the picture of the disease indicates the type of surgical intervention.
If the cancer is located in the head of the pancreas or in the area of the opening of the pancreatic duct, then the doctors perform Whipple's surgery. In the presence of a malignant process in the area of the body or the tail of the pancreas, surgeons perform pancreatectomy.
The operation (pancreatoduodenal resection or Whipple's surgery) was first performed in early 1930 by physician Alan Whipple. In the late 60s, mortality from such an intervention had rather high statistics.
To date, pancreatoduodenal resection is considered completely safe. Mortality rates dropped to 5%. The final result of the intervention directly depends on the professional experience of the surgeon.
What is the process
Let us consider in more detail how pancreatoduodenal resection is performed. The steps of the operation are outlined below. In the process of conducting this kind of operation, the patient is removed from the head of the pancreas. In severe cases of the disease, partial removal of the bile duct and duodenum is performed. If a malignant tumor is localized in the stomach, then its partial removal is performed.
After pancreatoduodenal resection, doctors connect the remaining segments of the pancreas. The bile duct is directly connected to the intestine. The time for such an operation is about 8 hours. After the operation, the patient is on outpatient treatment, which takes about 3 weeks.
Whipple Laparoscopy
This method of treatment is carried out based on the location of the malignant neoplasm. Whipple laparoscopy can significantly reduce the patient's rehabilitation period. This type of surgery is performed in patients with ampullar cancer.
Laparoscopic surgery is performed through small incisions in the abdominal region. It is done by experienced surgeons using special medical equipment. In a typical Whipple operation, abdominal incisions of impressive dimensions are performed.
During laparoscopic surgery, surgeons note the least blood loss during surgical procedures. They also note a minimal risk of introducing various infections.
When Whipple's Surgery Is Necessary
There are a number of indicators in which the operation is able to completely correct the patient's condition. These include:
- Cancerous lesion of the head of the pancreas (pancreatoduodenal resection of the pancreas is performed).
- Malignant neoplasm in the area of the duodenum.
- Cholangiocarcinoma. In this case, the tumor affects the healthy cells of the bile ducts of the liver.
- Ampullary cancer. Here, a malignant neoplasm is located in the area of the pancreatic duct, which removes bile into the duodenum.
Surgery of this kind is also used for disorders of benign tumors. These include a disease such as chronic pancreatitis.
Approximately 30% of patients undergo this type of treatment. They are diagnosed with tumor localization within the pancreas. Due to the lack of accurate symptoms, in most cases, patients undergo a process of metastasis of other organs. To carry out an operation with this course of the disease does not make sense.
Pancreatoduodenal resection begins with an accurate diagnosis of the affected organs. Submission of appropriate tests will show a picture of the course of the disease.
The small size of the cancer tumor allows for laparoscopic surgery. As a result, surgeons manage to completely remove the affected area, while not harming other organs of the abdominal cavity.
Treatment Summary
Most patients ask the same question: what are the consequences of pancreatoduodenal resection? Over the past 10 years, the mortality rate of patients has decreased to 4%. The fact is that a positive result is achieved with the vast experience of the surgeon performing the operation.
With Whipple pancreatic adenocarcinoma, approximately 50% of patients survive. With the complete absence of tumors in the lymphatic system, such measures increase the survival of patients several times.
At the end of the operation, the patient is prescribed a course of radio and chemotherapy. This is necessary in order to destroy the spread of cancer cells to other organs.
Further treatment after surgery is contraindicated in patients with a benign tumor, as well as with neuroendocrine changes.
Pancreatoduodenal resection: surgery technique
During the surgical process, most of the organ that is responsible for the release of insulin is removed. In turn, it helps control the level of sugar in the circulatory system. Partial resection significantly reduces insulin production. As a result, in most patients, the risk of developing a disease such as diabetes is sharply increased.
Patients with high blood sugar are most susceptible to this kind of disease. A normal glucose level in a patient with no chronic pancreatitis dramatically reduces the development of diabetes.
At the end of the rehabilitation process, the attending physician recommends a diet. It is necessary to exclude too fatty and salty foods from the diet. Often after this kind of intervention, many patients had intolerance to sugary foods. In this case, its use is contraindicated.
Complications after Whipple's Surgery
This type of treatment has rather high risks of complications. The presence of professional experience with the surgeon significantly reduces the appearance of any troubles. Potential problems include:
- The appearance of a pancreatic fistula. During the surgical intervention, the surgeon connects the gland to the intestinal section. The soft tissue of the pancreatic organ interferes with the rapid healing of the suture. During this period, a loss of pancreatic juice occurs.
- Partial paralysis of the stomach. At the end of the operation, the patient is prescribed a course of injection through a dropper. This is necessary in order to restore the normal functioning of the stomach.
Nutrition after pancreatoduodenal resection should be correct, all bad habits must be eliminated. Subject to all recommendations, a person gradually returns to normal life.