Associate Professor from the Department of General Surgery at Memorial Kayseri Hospital. Dr. Türkmen Bahadır Arıkan talked about pancreatic cancer and gave information about Whipple surgeries.
The pancreas, which is a very important organ for human life, is located in the body in a structure that extends from the back of the stomach to the spleen and is surrounded by the duodenum. The middle part is called the 'neck' or 'trunk' and the thin end is defined as the 'tail'. The pancreas produces enzymes that digest proteins, carbohydrates and fats that come from the stomach to the duodenum and discharge them into the duodenum. Stating that it is the hormone insulin that controls blood sugar level, Assoc. Dr. Türkmen Bahadır Arıkan, “An uncontrolled growth and tumor formation in the pancreas is called pancreatic cancer. The tumor arises in the head, 75% of the pancreas, and the neck or trunk of the remainder. It is estimated that pancreatic cancer, which ranks 4th in cancer-related death toll, will rise to 2030nd rank in 2. In the USA, approximately 57 thousand people are diagnosed with pancreatic cancer every year and approximately 46 thousand patients die. he said.
Assoc. Dr. Türkmen Bahadır Arıkan listed the surgeries performed in pancreatic cancer as follows:
“For tumors or cysts in the body and tail of the pancreas, surgery to remove the left side of the pancreas (body and tail) is called a “distal pancreatectomy.” During this procedure, the spleen can also be removed during the operation.
In some pancreatic tumors, it may be necessary to remove the entire pancreas. This is called a "total pancreatectomy". People can live without a pancreas but will need lifelong insulin and enzyme replacement.
Pancreatic tumors can also affect vital blood vessels that pass near them. If the tumors involve nearby blood vessels, the patient is evaluated by the multidisciplinary council (oncologist, radiologist, gastroenterologist and general surgeon specializing in pancreatic surgery). The procedure of removing and re-suturing the involved vessel with direct surgery can also be applied. Patients with extensive vascular involvement are not suitable for surgery and chemotherapy treatment is planned.”
“What is Whipple surgery?”
Stating that Whipple surgery, also known as “pancreaticoduodenectomy”, is a complex operation performed to remove the head of the pancreas, the first part of the small intestine (duodenum), gallbladder and bile duct, Assoc. Dr. Türkmen Bahadır Arıkan said the following about the Whipple surgery:
“It is done to treat tumors and other disorders in the pancreas, intestine, and bile duct.
It is the most commonly used surgical technique to treat pancreatic head cancer.
It is a life-saving surgical method for patients diagnosed with cancer.
It is a treatment option used to stop the spread (metastasis) of cancer to other organs.
Whipple surgery can be performed for approximately 15% to 20% of patients diagnosed with pancreatic cancer, while a 15% patient group becomes suitable for surgery after chemotherapy treatment. Whipple, which is a very complex surgery, should be performed in a surgeon and center experienced in this field, as it will bring serious risks.”
Stating that Whipple surgeries last 4-8 hours and which technique to use is decided according to the condition of the patient and the tumor, Assoc. Dr. Türkmen Bahadır Arıkan said that the operation can be performed in two ways. During open surgery, the surgeon creates an incision in the abdomen to access the pancreas. Stating that this is the most common and most applied approach, Assoc. Dr. Türkmen Bahadır Arıkan said, “During closed, that is, laparoscopic surgery, the surgeon makes several small incisions in the abdomen and the surgery is performed with the help of special instruments, including a camera that transmits the image to a monitor in the operating room. The surgeon watches the monitor to guide the surgical instruments while performing the operation. Laparoscopy is a type of minimally invasive surgery.
In minimally invasive surgery; blood loss is less and the risk of complications is also reduced. It is a comfortable method that allows the patient to recover in a shorter time. Although the operative time is long, sometimes this procedure can start with minimally invasive surgery, but complications or technical difficulties may require the surgeon to make an open incision to finish the operation.” said.
Assoc. Dr. Türkmen Bahadır Arıkan said that Whipple surgery was performed in the following cases:
- Pancreatic cancer
- Pancreatic cysts
- Pancreatic tumors
- Pancreatitis
- Ampulla cancer
- Bile duct cancer
- Neuroendocrine tumors
- Twelve Fingers (Duodonum) Cancer
- Trauma to the pancreas or small intestine
- Other tumors or disorders involving the pancreas, duodenum, or bile ducts.
“Close follow-up after Whipple surgery is important”
Stating that the patient needs to be hospitalized in the general surgery service for at least one week after surgery, Assoc. Dr. Türkmen Bahadır Arıkan said, “All surgical team and nursing staff will monitor the patient for signs of infection or complications to keep his condition under control. The diet will progress as slowly as tolerated. Most patients can walk immediately after the operation. In some cases, hospitalization in the intensive care unit for a few days may be required depending on the condition of the surgery and the patient. ICU doctors and nurses will monitor the patient's condition to monitor for signs of complications.” he said.
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