Whipple Procedure
The major curative operation for pancreatic head and periampullary cancer — removing the head, duodenum, and bile duct.
What is Whipple Procedure?
The Whipple procedure (pancreaticoduodenectomy) is a major upper gastrointestinal operation in which the head of the pancreas, duodenum, proximal jejunum, gallbladder, and common bile duct are excised en bloc, followed by reconstruction with pancreaticojejunostomy, hepaticojejunostomy, and gastrojejunostomy. It is the standard curative-intent operation for resectable cancer of the pancreatic head and periampullary region. Dr. Tagore Mohan Grandhi performs Whipple's procedure with careful patient selection, optimised peri-operative care, and meticulous surgical technique to minimise morbidity, supported by a multidisciplinary HPB team.
How the Procedure Works
Patient Positioning
Patient placed supine under general anaesthesia. Upper midline or bilateral subcostal incision. Pylorus-preserving modification used in most cases to reduce post-operative dumping.
Exploration and Resectability Assessment
Abdomen explored to exclude peritoneal or hepatic metastases. Superior mesenteric vein–portal vein confluence assessed for involvement.
Resection Phase
Gallbladder, common bile duct, head and uncinate process of the pancreas, duodenum, proximal jejunum, and regional lymph nodes excised as a single specimen. Pancreatic neck divided with frozen section margin assessment.
Reconstruction Phase
Continuity restored with three anastomoses: pancreaticojejunostomy, hepaticojejunostomy, and duodenojejunostomy or gastrojejunostomy on a single Roux-en-Y jejunal limb.
Post-operative Care
Drains left in situ. Drain amylase checked on day three to detect pancreatic fistula. Enhanced recovery protocol. Pancreatic enzyme replacement (PERT) commenced. Adjuvant chemotherapy planned.
Outcomes
Who Needs This Treatment?
- →Only potentially curative operation for resectable pancreatic head and periampullary cancer
- →Pylorus-preserving modification reduces post-operative dumping and nutritional morbidity
- →Multidisciplinary HPB team optimises peri-operative nutrition, oncological planning, and recovery
- →Pancreatic exocrine supplementation commenced early to maintain nutritional status
Whipple's procedure remains one of the most demanding operations in abdominal surgery. With careful patient selection, expert peri-operative care, and a dedicated HPB team, we achieve safe outcomes and give our patients the best chance of long-term survival.
— Dr. Tagore Mohan Grandhi, Senior Consultant Gastrointestinal Surgeon, Lux Hospitals, Hyderabad
Common Questions
Frequently Asked Questions
Not sure which treatment is right for you?
Book a consultation with Dr. Tagore Grandhi and get a personalised treatment plan.