Today, pancreatic cancer is a common type of cancer. In most cases, the prognosis is rather bad. During the examination, doctors detect the presence of secondary metastases that affect he althy tissue in other organs.
The main disadvantage of this disease is that there are no symptoms of the manifestation 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 procedures.
Technology of pancreatoduodenal resection
Who can be recommended pancreatoduodenal resection? Surgical intervention is indicated only for those patients in whom cancerous tumors have a clear localization within the pancreas. Such surgery acts as a healing process.
Before starting the operation, the attending physician conducts a complete diagnosis of the affected organ. Thanks toultrasound examination and many tests, 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 region of the opening of the pancreatic duct, then doctors perform the Whipple operation. In the presence of a malignant process in the body or tail of the pancreas, surgeons perform a pancreatectomy.
The operation (pancreatoduodenal resection or Whipple's operation) was first performed in the early 1930s by physician Alan Whipple. In the late 60s, the mortality rate from such an intervention had a fairly high statistics.
Today, 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's take a closer look at how pancreatoduodenal resection is performed. The steps of the operation are outlined below. In the process of carrying out this kind of operation, the patient performs the removal of the head pancreas. In severe cases of the disease, partial removal of the bile duct and duodenum is performed. If the 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 duration of such an operation isabout 8 hours. After the operation, the patient is on outpatient treatment, which takes about 3 weeks.
Whipple Laparoscopy
This method of treatment is based on the location of the malignant neoplasm. Whipple laparoscopy can significantly reduce the rehabilitation period of the patient. This type of surgery is performed on patients with ampullary cancer.
Laparoscopic intervention is performed through small incisions in the abdominal region. It is done by experienced surgeons using special medical equipment. In a conventional Whipple operation, large abdominal incisions are made.
During laparoscopic surgery, surgeons note the least blood loss during surgical manipulations. They also note the minimal risk of introducing various kinds of infections.
When a Whipple operation is needed
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 being performed).
- Malignant neoplasm in the duodenum.
- Cholangiocarcinoma. In this case, the tumor affects he althy cells in the bile ducts of the liver.
- Ampullary cancer. Here, the malignant neoplasm is located in the region of the pancreaticduct that carries bile into the duodenum.
Surgical intervention of this kind is also used in 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 localization of the tumor within the pancreas. Due to the lack of accurate symptoms, in most cases, patients undergo a process of metastasis to other organs. It makes no sense to perform an operation with such a course of the disease.
Pancreatoduodenal resection begins with an accurate diagnosis of the affected parts of the organ. Passing the appropriate tests will show a picture of the course of the disease.
The small size of the cancer allows laparoscopic intervention. As a result, surgeons are able to completely remove the affected area without harming other abdominal organs.
Treatment outcomes
Most patients ask the same question: what are the consequences of pancreaticoduodenal 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 adenocarcinoma of the pancreas, Whipple's operation saves the lives of approximately 50% of patients. 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 patienta course of radio and chemotherapy is prescribed. 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: operation technique
In the process of surgical intervention, a large part of the organ that is responsible for the release of insulin is removed. In turn, it helps to control the level of sugar in the circulatory system. Partial resection significantly reduces insulin production. As a result, the risk of developing a disease such as diabetes mellitus increases dramatically in most patients.
Patients with high blood sugar levels are most susceptible to this kind of disease. A normal glucose level in a patient without chronic pancreatitis dramatically reduces the development of diabetes.
At the end of the rehabilitation process, the attending physician recommends a diet. Too fatty and s alty foods should be excluded from the diet. Often after this kind of intervention, many patients noted intolerance to sweet foods. In this case, its use is contraindicated.
Complications after Whipple surgery
This type of treatment has a fairly high risk of complications. The presence of professional experience of the surgeon significantly reduces the appearance of any troubles. For potential problemsrefer to:
- The appearance of a pancreatic fistula. During the surgical intervention, the surgeon connects the gland with the intestinal section. The soft tissues of the pancreatic organ interfere with the rapid healing of the suture. During this period, there is a loss of pancreatic juice.
- Partial paralysis of the stomach. At the end of the operation, the patient is given 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 excluded. Subject to all recommendations, a person gradually returns to normal life.
