1 / 9

Pa n creaticoduodenectomy The Whipple Procedure

By Preston Paynter and Brielle Bowyer. Pa n creaticoduodenectomy The Whipple Procedure. Reasons for Procedure. Pancreatic Cancer Chronic Pancreatitis Severe trauma to the Pancreas. Diagnostic Procedures. CT scan Needle biopsy Cholangiopancreatography Endoscopic ultrasound

talib
Download Presentation

Pa n creaticoduodenectomy The Whipple Procedure

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. By Preston Paynter and Brielle Bowyer PancreaticoduodenectomyThe Whipple Procedure

  2. Reasons for Procedure • Pancreatic Cancer • Chronic Pancreatitis • Severe trauma to the Pancreas

  3. Diagnostic Procedures • CT scan • Needle biopsy • Cholangiopancreatography • Endoscopic ultrasound • Palpation of the pancreas

  4. Procedure Summary • Resection • Part or all of the pancreas, duodenum, gallbladder, distal stomach and surrounding lymph nodes are identified and removed. • Reconstruction • Attachment of left over stomach, left over pancreas, and common bile duct to the jejunum. ** Class II wound unless spillage occurs.

  5. Supplies and Instrumentation • Supplies • Prep set • Basic pack • Basin set • Blades • #10 • #11 • Laparotomy drapes • Bovie • Suture • Doctors Pref. • Dressing • Doctors Pref. • Hemostatic agents • Suction • Head lamp • Instrumentation • Major instrument set • Vascular instruments • Biliary instruments (in room) • Long instruments • Bowl resection set • Retractors • Hand held • Self Retaining • Ligating clip appliers and clips • Staplers • Drains

  6. Operative Prep • Anesthesia • General • Positioning • Supine with arms on arm boards • Skin Prep • Shave • Begin where incision will be. • Extends from chest to upper thighs and down to the table on both sides • Draping • Lap sheet outlined with towels • Incision • Left Sub-costal or upper midline **Special consideration -Lubricate and protect the patient’s eyes

  7. Operative Procedure Resection • Incision is made • Exploration of the abdomen and assessment of the extent and resectability of the tumor is made. • Cholecystectomy • Removal of Lymph nodes in the surrounding area • Partial Gastrectomy • Vagotomy • Division of the Pancreas • Dissection of the retro-pancreatic vessels • Removal of Duodenum

  8. Operative Procedure Reconstruction • Pancreaticojejunostomy • Hepaticojejunostomy • End-to-side gastrojejunostomy • NG tube placed • Drains placed behind the pacreatic and biliaryanastomoses • Stab wound made on the right side of the abdomen where drain tube exits. • Secured at the skin level with 3-0 silk • Counts take place • 4 total Counts • Abdomen closed

  9. Post-Op • Immediate Postoperative Care • Transport to PACU • Possible Complications • Hemorrhage • Wound Infection • Fistula formation • Recurrence of Pathology • Leakage of Anastomosis • Nutritional/Digestive concerns • Ileus • Prognosis • Depends on response to primary condition • Mortality rate is 5% when surgery is performed by an experienced surgeon.

More Related