Suite 411, Netcare Unitas / Suite 206, Midstream Mediclinic
WHIPPLE’S (PANCREATICODUODENECTOMY)
THIS IS A MAJOR OPERATION TO REMOVE THE HEAD OF THE PANCREAS.

Indications:

A Whipple’s resection is performed with the intention of obtaining complete removal of a suspected tumour, situated in the head of the pancreas. The operation is only of potential benefit if the tumour can be completely removed. It is also used for the treatment of pancreatic or duodenal trauma, or chronic pancreatitis.

Procedure:

An incision (cut) is made in the midline just below the ribs down to and extended a bit next to the belly button. The abdomen is checked to make sure there are no signs of tumour spread beyond the pancreas. There are variations in how the operation is performed and the stomach may be left in total or only a small portion removed. The head half of the pancreas is then cut out, leaving behind the tail half of the pancreas. The head of the pancreas is closely attached to the duodenum (first part of the small bowel after the stomach), and the bile duct coming from the liver runs through the pancreas. The duodenum and bile duct with the gallbladder are also removed. The stomach, top end of the bile duct below the liver, and tail end of the pancreas are then each joined separately to the small intestine to allow for proper digestion. If it is discovered at surgery that the tumour has spread further than was seen on the scans, and that removal of the pancreas will not remove all the tumour, then a bypass procedure may be performed. Here the bile duct and stomach are stitched to the small bowel, in order to relieve blockages, but the pancreas is not removed.

A complication of some description occurs in around 40% of patients. These complications are usually minor, and although they result in a prolonged hospital stay, usually resolve on their own.

  • The most significant complications are related to leaks from any of the three major joins, particularly leaks from the join between the pancreas and the intestine.
  • In up to 5% of cases complications can be more serious and result in death or a second operation.
  • In the long term having a reduced amount of pancreas can cause you to become diabetic and require insulin.
  • You can also develop impaired digestion of food and resultant fatty stools (steatorrhoea). This is treated with enzyme replacement capsules.
  • One of these problems occurs in about a third of people in the long term.

After your consultation:

  • Obtain authorization from your medical aid and book your bed for your hospital admission.
  • Carefully read through pre-operative information provided.

Day before surgery:

  • Do not eat/drink after 22h00, the night before your surgery, unless otherwise specified by your surgeon or anaesthetist  (you should be fasting for at least 6 hours before the procedure for solids but you are allowed to take clear liquids up to two hours before your procedure).

Day of surgery:

  • Arrive for admission at indicated time on ‘Code & Consent’ sheet.
  • Change into theatre attire, remove all valuable belongings.

This is a very long and complex procedure and can be quite variable in length. It is usually at least 6-7 hours in duration.

Duration of hospital stay:

  • If everything goes smoothly the usual stay is 7-14 days. However, if there are any complications such as a leak from the pancreas the stay may be longer.

Activities:

  • You can start walking straight away, but it is likely to be several weeks before you are back to full strength and activity.

Back to work:

  • You should expect to be off work for at least 4 to 6 weeks depending on the recovery and whether complications occurred.

Some pain and discomfort post operatively may be expected following any operation, but the following measures are used to lessen the pain experienced:

  • Warming devises in theatre as well as warm intravenous fluids.
  • Intra-operative pain medication through the drip.
  • Post-operative medication through the drip, please inform the nurses if you are in pain so that medication will be administered to you.
  • As close to one week after discharge as possible. Please contact the rooms to schedule an appointment.
If you experience any worrisome problems, please contact the rooms during working hours or the emergency number (012) 333 6000 after hours.

More procedures performed by Dr Basson & Jeske

ABSCESS DRAINAGE
ABSCESS DRAINAGE

A SKIN INCISION IS MADE AND THE CONTENTS OF THE ABSCESS IS DRAINED.

ADRENALECTOMY (OPEN/LAPAROSCOPIC)
ADRENALECTOMY (OPEN/LAPAROSCOPIC)

AN OPERATION TO REMOVE ONE (OR BOTH) ADRENAL GLANDS.

ANAL FISTULECTOMY
ANAL FISTULECTOMY

THE FISTULA TRACT IS IDENTIFIED AND IS OPENED ALONG ITS LENGTH, AND THE EXPOSED INSIDE OF THE TRACT IS THEN CLEANED OUT.

APPENDISECTOMY (LAPAROSCOPIC/OPEN)
APPENDISECTOMY (LAPAROSCOPIC/OPEN)

AN OPERATION TO REMOVE AN APPENDIX THAT IS INFLAMED/SWOLLEN/HAS RUPTURED/HAS FORMED AN ABSCESS.

BILE DUCT EXPLORATION
BILE DUCT EXPLORATION

THE COMMON BILE DUCT (CBD – THE MAIN TUBE CARRYING BILE FROM THE LIVER TO THE INTESTINE) IS OPENED UP. ANY GALLSTONES WITHIN THE DUCT CAUSING A BLOCKAGE CAN BE REMOVED.

BREAST LUMPECTOMY
BREAST LUMPECTOMY

AN OPERATION TO REMOVE LUMPS/TUMOURS OF THE BREAST.

COLECTOMY
COLECTOMY

AN OPERATION TO REMOVE PART OF/THE ENTIRE COLON.

COLONOSCOPY
COLONOSCOPY

AN ENDOSCOPIC EXAMINATION OF THE LARGE INTESTINE (COLON & RECTUM).

DISTAL PANCREATECTOMY
DISTAL PANCREATECTOMY

THE PANCREAS IS EXPOSED AND FREED FROM THE ADJACENT ORGANS. THE TAIL (DISTAL) HALF OF THE PANCREAS IS REMOVED. THE BLOOD VESSELS THAT GO TO THE SPLEEN PASS THROUGH THE PANCREAS. AS A RESULT THE SPLEEN ALSO SOMETIMES NEEDS TO BE REMOVED.

DRAINAGE PERI-ANAL ABSCESS
DRAINAGE PERI-ANAL ABSCESS

AN INCISION IN THE SKIN NEXT TO THE ANUS TO DRAIN PUS.

ERCP
ERCP

ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY, INVOLVES PASSING A FLEXIBLE ENDOSCOPE (DUODENOSCOPE) THROUGH THE MOUTH AND STOMACH TO THE FIRST PART OF THE BOWEL CALLED THE DUODENUM.

FEMORAL HERNIA REPAIR (OPEN)
FEMORAL HERNIA REPAIR (OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN THE MUSCLES WHICH FORM THE LOWER FRONT OF THE STOMACH (IN THE GROIN REGION).

GASTRECTOMY
GASTRECTOMY

AN OPERATION THAT REMOVES EITHER PART OF THE STOMACH (PARTIAL) OR THE ENTIRE STOMACH (TOTAL).

GASTROSCOPY
GASTROSCOPY

AN ENDOSCOPIC EXAMINATION OF THE STOMACH.

HAEMORRHOIDECTOMY
HAEMORRHOIDECTOMY

AN OPERATION TO REMOVE COMPLICATED HAEMORRHOIDS (PILES).

INCISIONAL HERNIA REPAIR (LAPAROSCOPIC/OPEN)
INCISIONAL HERNIA REPAIR (LAPAROSCOPIC/OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN AN AREA WHERE PREVIOUS MUSCLE CLOSURE HAS BEEN PERFORMED (AFTER AN ABDOMINAL OPERATION).

INGUINAL HERNIA REPAIR (OPEN/LAPAROSCOPIC)
INGUINAL HERNIA REPAIR (OPEN/LAPAROSCOPIC)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS IN THE MUSCLES WHICH FORM THE LOWER FRONT OF THE STOMACH (IN THE GROIN REGION).

LAPAROSCOPIC CHOLECYSTECTOMY (GALL STONES)
LAPAROSCOPIC CHOLECYSTECTOMY (GALL STONES)

REMOVAL OF GALLBLADDER BY MEANS OF MINIMALLY INVASIVE “KEY-HOLE SURGERY”.

LIVER BIOPSY
LIVER BIOPSY

THE DOCTOR WILL TAKE A VERY SMALL PIECE OF YOUR LIVER (ABOUT 1/50,000TH OF YOUR LIVER) TO SEND FOR FURTHER TESTS.

LIVER RESECTION
LIVER RESECTION

THE SURGICAL REMOVAL OF PART OF THE LIVER.

MASTECTOMY
MASTECTOMY

AN OPERATION TO REMOVE THE ENTIRE BREAST

NEUROSTIMULATOR IMPLANT
NEUROSTIMULATOR IMPLANT

WITH INTERSTIM THERAPY, A SACRAL NEUROMODULATION DEVICE IS IMPLANTED DURING A MINIMALLY INVASIVE PROCEDURE.

NISSEN FUNDOPLICATION (LAPAROSCOPIC)
NISSEN FUNDOPLICATION (LAPAROSCOPIC)

AN OPERATION PERFORMED TO RELIEVE GASTRO-OESOPHAGEAL REFLUX; MOST OFTEN ASSOCIATED WITH A HIATUS HERNIA.

OESOPHAGEAL MANOMETRY
OESOPHAGEAL MANOMETRY

OESOPHAGEAL MANOMETRY IS A TEST THAT MEASURES THE FUNCTION AND MOVEMENT OF THE OESOPHAGUS AND THE CHARACTERISTICS OF THE VALVE BETWEEN THE OESOPHAGUS AND THE STOMACH.

PARATHYROIDECTOMY
PARATHYROIDECTOMY

AN OPERATION TO REMOVE PARATHYROID GLAND/S OR PARATHYROID TUMOURS.

PERCUTANEOUS ENDOSCOPIC GASTROSTOMY
PERCUTANEOUS ENDOSCOPIC GASTROSTOMY

A PEG IS A WAY OF INTRODUCING FOOD, FLUIDS AND MEDICINES DIRECTLY INTO THE STOMACH BY PASSING A THIN TUBE THROUGH THE SKIN AND INTO THE STOMACH.

PILONIDAL ABSCESS/SINUS EXCISION
PILONIDAL ABSCESS/SINUS EXCISION

AN ELLIPTICAL INCISION IS MADE REMOVING THE AFFECTED SKIN AND INVOLVED TISSUE OVER THE BUTTOCK CLEFT.

RECTAL PROLAPSE (ABDOMINAL REPAIR)
RECTAL PROLAPSE (ABDOMINAL REPAIR)

AN OPERATION PERFORMED TO REPAIR A RECTUM THAT PROLAPSES THROUGH THE ANUS.

RECTOCELE REPAIR
RECTOCELE REPAIR

AN OPERATION PERFORMED TO STRENGTHEN THE WALL OF THE VAGINA WHICH STOPS THE RECTUM FROM PROTRUDING INTO THE VAGINA.

SMALL BOWEL RESECTION
SMALL BOWEL RESECTION

SURGERY TO REMOVE A PART OF YOUR SMALL BOWEL.

SPLENECTOMY (LAPAROSCOPIC/OPEN)
SPLENECTOMY (LAPAROSCOPIC/OPEN)

AN OPERATION TO REMOVE THE SPLEEN.

STOMA CREATION/CLOSURE
STOMA CREATION/CLOSURE

A STOMA IS AN OPENING ANYWHERE ALONG THE LENGTH OF THE BOWEL TO THE EXTERIOR SKIN SURFACE TO CREATE AN ARTIFICIAL ANUS.

THYROIDECTOMY
THYROIDECTOMY

AN OPERATION TO REMOVE PART OF/THE ENTIRE THYROID GLAND.

TOTAL PANCREATECTOMY
TOTAL PANCREATECTOMY

REMOVING YOUR WHOLE PANCREAS, YOUR DUODENUM, A SMALL PORTION OF YOUR STOMACH, THE GALLBLADDER AND PART OF YOUR BILE DUCT, YOUR SPLEEN AND MANY OF THE SURROUNDING LYMPH NODES.

UMBILICAL HERNIA REPAIR (OPEN)
UMBILICAL HERNIA REPAIR (OPEN)

AN OPERATION TO REPAIR AN AREA OF WEAKNESS/SWELLING OF THE NAVEL (BELLY BUTTON).

WHIPPLE’S (PANCREATICODUODENECTOMY)
WHIPPLE’S (PANCREATICODUODENECTOMY)

THIS IS A MAJOR OPERATION TO REMOVE THE HEAD OF THE PANCREAS.