Whipple procedure (pancreaticoduodenectomy)
The big operation for cancers of the head of the pancreas: the surgeon removes the pancreatic head, the duodenum, the gallbladder and part of the bile duct, then reconnects everything.
Named after Allen Whipple (1935), it is the only curative option for pancreatic head, distal bile duct and ampullary cancers, and is offered only when imaging shows the tumour can be fully removed (resectable or borderline resectable after neoadjuvant therapy). It takes 5-8 hours, carries 2-4% mortality and 30-40% major complication rates (pancreatic fistula, delayed gastric emptying), and most patients need enzyme supplements afterwards. Distal pancreatectomy removes the tail instead. Neoadjuvant chemotherapy (FOLFIRINOX) and RAS inhibitors are increasing the share of patients who reach an R0 resection.
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