On Oct. 12, President Ron Daniels successfully underwent Whipple surgery at the Hopkins Hospital.
Whipple surgery, also known as pancreaticoduodenectomy, is a procedure typically used to treat pancreatic cancer by removing the affected region. Pancreatic cancer is among the deadliest of cancers: Within five years after diagnosis, just one out of every 20 people diagnosed with it will still be alive.
Pancreatic cancer can be spotted using CAT scans and other tests, but is more commonly diagnosed from its symptoms: abdominal pain and weight loss, and, if the tumor affects the common bile duct, jaundice, a condition in which the eyes and skin turn yellow.
The pancreas, which produces digestive enzymes that break down food in the small intestine, along with insulin and glucagon, the hormones that regulate blood sugar levels, is located between the duodenum (the first section of the small intestine), the stomach and the spleen.
If the tumor has not spread beyond the pancreas and does not get intertwined with nearby blood vessels, the cancer could possibly be entirely removed. However, the head of the pancreas, nestled into a loop of the duodenum, shares a common blood supply with various other nearby organs, complicating the procedure.
The Whipple surgery, first performed by Allen Whipple in 1935, is used to safely remove the head of the pancreas. The surgeon removes the head of the pancreas, the duodenum, the gall bladder (which stores bile, the compound that digests fatty food in the stomach) and the common bile duct (which connects the duodenum, the gall bladder and the liver). Sometimes, even part of the stomach is removed.
If a cancer is suspected of having spread to local lymph nodes, these may be removed in order to prevent it from spreading throughout the lymphatic system. The small intestine is resealed and the rest of the pancreas is reconnected to the bile duct and stomach.
The procedure generally lasts between four and seven hours, and patients are typically hospitalized for a week to 10 days following the procedure, as the digestive system adjusts to being rearranged.
Whipple surgery is not only used for pancreatic cancer. It can be used for all sorts of tumors in the head of the pancreas, duodenum, gall bladder and elsewhere in the gastrointestinal system. Daniels had a gastrointestinal stromal tumor, a rare, generally benign tumor in the duodenum.
The survival rate for Whipple surgery has improved significantly over time.? In the 1970s, 15 percent of patients who had a Whipple surgery died during or shortly after the procedure. However, when the surgery is conducted at hospitals that regularly perform them, the mortality rate has declined to under four percent.
"The Whipple procedure is performed here three to five times per week, as we are a major referral center and have many noted surgeons who have significant, perhaps the most, experience in North America," John Ulatowski, the anesthesiologist for Daniels' surgery, said.
"We have collaboratively developed a highly successful protocol for the care of patients having this surgery, which includes a well-established anesthetic plan."
