TY  - CHAP
M1  - Book, Section
TI  - PANCREATICODUODENECTOMY (WHIPPLE PROCEDURE)
A1  - Ellison, E. Christopher
A1  - Zollinger, Robert M.
PY  - 2016
T2  - Zollinger's Atlas of Surgical Operations, 10e
AB  - The  head  of  the  pancreas  is  usually  removed  for  malignancy  involving  the  ampulla  of  Vater,  the  lower  end  of  the  common  duct,  the  head  of  the  pancreas,  or  the  duodenum.  With  increasing  frequency,  Whipple  is  indicated  for  the  risk  of  malignancy  associated  with  the  presence  of  a  cystic  neoplasm  with  worrisome  features.  Far  less  frequently,  the  procedure  is  carried  out  to  manage  intractable  pain  associated  with  a  chronic  calcific  pancreatitis  or  for  massive  trauma  when  there  has  been  irreparable  “burst”  damage  to  the  head  of  the  pancreas,  the  ductal  structures,  and  the  duodenum.  In  the  presence  of  malignancy,  the  resection  is  indicated  in  the  absence  of  proven  metastases  and  if  the  tumor  is  of  such  a  limited  size  that  the  portal  vein  is  not  involved  beyond  the  ability  of  the  surgeon  to  accomplish  a  safe  vascular  resection  and  repair.  Total  pancreatectomy  may  be  considered  in  some  cases  due  to  central  location  of  a  malignant  tumor  or  extensive  main  duct  involvement  by  papillary  mucinous  epithelium  (IPMN).  While,  total  pancreatectomy  decreases  the  incidence  of  postoperative  complications  related  to  the  leakage  of  pancreatic  juice  from  an  anastomosis,  the  subsequent  endocrinopathy  can  be  profound.  The  patient  should  be  made  aware  of  the  problem  of  diabetes  mellitus  after  operation  as  well  as  the  need  for  daily  pancreatic  enzyme  replacement.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/20
UR  - accesssurgery.mhmedical.com/content.aspx?aid=1127273702
ER  -