Pancreatoduodenal resection: treatment and complications

To date, pancreatic cancer is a common type of cancer. In most cases, the forecast has rather bad consequences. During the examination, doctors detect the presence of secondary metastases, which affect the healthy tissues of 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. When a large number of metastases are detected, patients are not subjected to surgical manipulation.

Technology of pancreatoduodenal resection

Who can be recommended pancreatoduodenal resection? Surgical intervention is indicated only for those patients whose cancerous tumors have a clear localization within the pancreas. Such surgery acts as a therapeutic process.

Before the beginning of the operation, the attending physician conducts a full diagnosis of the affected organ. Due to ultrasound examination and a variety of analyzes, the disease pattern indicates the type of surgical intervention.

If the cancer is located in the head of the pancreas or around the opening of the pancreatic duct, the doctors perform Whipple's operation. In the presence of malignant process in the body or tail of the pancreas, pancreatectomy is performed.

The operation (pancreatoduodenal resection or Whipple operation) was first performed in the beginning of 1930 by a physician Alan Whipple. At the end of the 1960s, the mortality from such interference was quite high.

To date, pancreatoduodenal resection is considered completely safe. Death rates dropped to 5%. The final result of the intervention depends on the professional experience of the surgeon.

What is the process

Let us consider in more detail how pancreatoduodenal resection is performed. The stages of the operation are outlined below. During this type of surgery, the patient is removed from the head pancreas. In severe disease, partial removal of the bile duct and duodenum is carried out. If a malignant tumor is localized in the area of the stomach, then its partial removal is performed.

After pancreatoduodenal resection, the physicians join the remaining segments of the pancreas. The bile duct is directly connected to the intestine. The time of such an operation is about 8 hours. After the operation, the patient is on outpatient treatment, which takes about 3 weeks.

Whipple's laparoscopy

This method of treatment is based on the location of the malignant neoplasm. Whipple's laparoscopy can significantly reduce the rehabilitation period of the patient. This type of surgery is performed in patients with ampullar cancer.

Laparoscopic intervention is performed through small incisions in the abdominal region. It is done by experienced surgeons with the help of special medical equipment. In the usual operation of Whipple, cavitary incisions of impressive dimensions are performed.

At a laparoscopic operation surgeons mark the smallest blood loss during operative manipulation. They also note a minimal risk of entering various kinds of infections.

When Whipple's operation is necessary

There are a number of indicators in which the operation is capable of completely correcting the patient's condition. These include:

• Cancer of the head of the pancreas (pancreatoduodenal resection of the pancreas).
• 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.
• Ampullar cancer. Here the malignant neoplasm is located in the area of the pancreatic duct, which leads to bile in the duodenum.

Surgical intervention of this kind is also used in disorders of benign tumors. They include a disease like chronic pancreatitis.

Approximately 30% of patients undergo this kind of treatment. They are diagnosed with tumor localization within the pancreas. Because of the lack of accurate symptoms in most cases, patients undergo metastasis of other organs. Doing an operation with such a course of the disease does not make sense.

Pancreatoduodenal resection begins with an accurate diagnosis of the affected parts of the organ. The delivery of appropriate analyzes will show the current course of the disease.

Small sizes of a cancerous tumor allow for laparoscopic intervention. As a result, surgeons manage to completely remove the affected area, while not harming other organs of the abdominal cavity.

Results of treatment

Most patients ask the same question: what are the consequences of pancreatoduodal resection? Over the past 10 years, the death rate of patients has decreased to 4%. The fact is that a positive result is achieved if there is a huge experience of the surgeon conducting the operation.

With adenocarcinoma, the Whipple pancreas operation allows saving about 50% of patients. With complete absence of tumors in the lymphatic system, such measures increase the survival rate of patients several times.

After the operation, the patient is assigned 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

In the process of surgical intervention, most of the organ that is responsible for isolating insulin is removed. In turn, it helps to control the level of sugar in the circulatory system. Partial resection significantly reduces the production of insulin. As a result, in most patients, the risk of developing such a disease as diabetes mellitus increases dramatically.

Patients with high blood sugar levels are most prone to this type of disease. The normal level of glucose in a patient with no chronic pancreatitis dramatically reduces the development of diabetes.

After the completion of the rehabilitation process, the attending physician recommends adhering to a diet. From the diet it is necessary to exclude too fatty and salty foods. Often after such an intervention, many patients showed intolerance to sweet food. In this case, its use is contraindicated.

Complications after Whipple's operation

This type of treatment has a relatively high risk of complications. Having a professional experience with a surgeon greatly reduces the occurrence of any trouble. Potential problems include:

• Appearance of fistula pancreatic. During the surgical intervention, the surgeon connects the gland with the intestinal department. Soft pancreatic organ tissues interfere with the rapid healing of the joint. 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 working capacity of the stomach.

Nutrition after pancreatoduodenal resection should be correct, all bad habits should be excluded. With all the recommendations, people gradually return to normal life.