What is a pancreatoduodenectomy (Whipples operation)?

The procedure is where the removal of part of the intestine pancreas (the gland that supplies digestive juices to the part of the intestine and bile ducts) to remove a possible tumor is done.

Anaesthetic

This procedure will require an anaesthetic.

What are the risks of this specific procedure?

There are risks and complications with this procedure.
They include but are not limited to the following:

General risks:

  • Infection can occur, requiring antibiotics and further treatment.
  • Bleeding could occur and may require a return to the operating room. Bleeding is more common if you have been taking blood thinning drugs such as Warfarin, Asprin, Clopidogrel (Plavix or Iscover) or Dipyridamole (Persantin or Asasantin).
  • Small areas of the lung can collapse, increasing the risk of chest infection. This may need antibiotics and physiotherapy.
  • Increased risk in obese people of wound infection, chest infection, heart and lung complications, and thrombosis.
  • Heart attack or stroke could occur due to the strain on the heart.
  • Blood clot in the leg (DVT) causing pain and swelling. In rare cases, part of the clot may break off and go to the lungs.
  • Death as a result of this procedure is possible

Specific risks:

  • The most serious problem is leakage of pancreatic, bile or gastric juices into the abdominal cavity, due to breakdown of the anastomosis. This may require further surgery or prolonged period of IV feeding.
  • Especially in a male there may be difficulty passing urine and a tube may need to be inserted in the bladder.
  • Deep bleeding in the abdominal cavity could occur and this may need fluid replacement or further surgery.
  • Damage of the bowel may occur which may cause leakage of bowel fluid. This may require further surgery.
  • Infections such as pus collections can occur in the abdominal cavity. This may need surgical drainage.
  • The bowel movement may be paralyzed or blocked after surgery and this may cause building up of fluid in the bowel with distention of the abdomen and vomiting. Further treatment may be necessary for this.
  • A weakness can occur in the wound with complete or incomplete, bursting of the wound in the short term, or a hernia in the long term. This may require further surgery.
  • In some people healing of the wound may be abnormal and the wound can be thickened and red and the wound may be painful.
  • Adhesions (bands of scar tissue) may form and cause bowel obstruction. This can be a short term or a long term complication and may need further surgery.
  • Unusual feeling after meals called “dumping”.
  • Nutritional problems such as weight loss, or anorexia due to removal of part of the stomach.
  • Increased risk in smokers of wound and chest infections, heart and lung complications and thrombosis.