Whipple Anatomy
Pancreaticoduodenectomy also referred to as the whipple or kausch whipple procedure is the most common surgical procedure for the resection of tumors in the pancreatic head uncinate process and neck as well as lesions of the ampulla extrahepatic bile duct and duodenum. Surgical anatomy of the superior mesenteric vein smv.
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The smv usually bifurcates into two main branches one to the ileum and one to the jejunum.
Whipple anatomy. A pancreatoduodenectomy commonly referred to as the whipple procedure in honor of the new york physician who perfected it allan whipple is famously complicated and demanding surgery that takes anywhere from four to 12 hours to complete. In 1935 whipple reported an improved version of the surgery and subsequently developed multiple refinements to his technique. Two roles one organ.
A quick anatomy lesson will make it clear why. Whipple surgery the most common technique of a pancreaticoduodenectomy consists of the en bloc removal of the distal segment antrum of the stomach the first and second portions of the duodenum the head of the pancreas the common bile duct and the gallbladder. The whipple procedure or partial pancreaticoduodenectomy is considered the definitive surgical operation to resect carcinoma of the head of the pancreas periampullary carcinoma or duodenal carcinoma 1.
Adequate venous return from the small bowel requires that one or the other of these two main smv tributaries is intact. Typically used to treat cancer or precancerous lesions at the head of the pancreas common bile duct cbd ampulla of vater or duodenum near the pancreas the whipple procedure consists of distal gastrectomy and removal of the pancreatic. About the whipple procedure this procedure is performed for tumors located in the head of the pancreas that are malignant though occasionally benign ones need to be removed as well.
These tumors can start in the pancreas itself the part of the bile duct which goes through the pancreas or the wall of the bowel the duodenum adherent to the pancreas. The jejunal branch of the smv often referred to as the first jejunal branch. The whipple procedure also known as pancreaticoduodenectomy was originally described by codivilla in 1898.
The pancreas has a dual function.
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