The extent of surgery of the pancreas is mainly dictated by the location of the disease, or whether it is done for tumors or pancreatitis. Pancreas surgery is one of the biggest and most involving surgeries in the abdomen, and that is due to the proximity of the pancreas to vital organs, in addition to important blood vessels.
The Whipple Procedure
For some patients who happen to have the disease in the head or neck of the pancreas, a Whipple procedure is indicated. The classic Whipple procedure is named after Allen Whipple, who was the first surgeon to perform the operation in 1935. The procedure is also known as pancreaticoduodenectomy, and it involves removal of the head of the pancreas, the first part of the small intestine (duodenum), in addition to a part of the bile duct, gallbladder, and a small part of the stomach. The pancreas, bile duct and the stomach are then reconnected to the intestines.
Very rarely, certain tumors involve the whole gland and thus a total pancreatectomy is required.
When the disease is found in the body or the tail of the pancreas, surgery is usually shorter and less challenging as it involves less organs. The body and tail of the pancreas are removed in addition to the spleen most of the time as it would be close and involved by the disease. Distal pancreatectomy can be easily done using minimally invasive surgery, using the small incisions camera technique, and we recently started performing these procedures using robotic surgery.