Pancreaticoduodenectomy
Overview
 
A pancreaticoduodenectomy, pancreatoduodenectomy, Whipple procedure, or Kausch-Whipple procedure, is a major surgical operation
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 involving the pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...

, duodenum
Duodenum
The duodenum is the first section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. In fish, the divisions of the small intestine are not as clear and the terms anterior intestine or proximal intestine may be used instead of duodenum...

, and other organs. This operation is performed to treat cancerous tumours
Pancreatic cancer
Pancreatic cancer refers to a malignant neoplasm of the pancreas. The most common type of pancreatic cancer, accounting for 95% of these tumors is adenocarcinoma, which arises within the exocrine component of the pancreas. A minority arises from the islet cells and is classified as a...

 on the head of the pancreas
Pancreas
The pancreas is a gland organ in the digestive and endocrine system of vertebrates. It is both an endocrine gland producing several important hormones, including insulin, glucagon, and somatostatin, as well as a digestive organ, secreting pancreatic juice containing digestive enzymes that assist...

, malignant tumors involving common bile duct
Common bile duct
The common bile duct is a tube-like anatomic structure in the human gastrointestinal tract. It is formed by the union of the common hepatic duct and the cystic duct . It is later joined by the pancreatic duct to form the ampulla of Vater...

, duodenal papilla, or duodenum near the pancreas.
This procedure was originally described by Alessandro Codivilla
Alessandro Codivilla
Alessandro Codivilla was an Italian surgeon.He was associated with early forms of pancreaticoduodenectomy and traction.- External links :* -References:...

, an Italian
Italian people
The Italian people are an ethnic group that share a common Italian culture, ancestry and speak the Italian language as a mother tongue. Within Italy, Italians are defined by citizenship, regardless of ancestry or country of residence , and are distinguished from people...

 surgeon, in 1898. The first resection for a periampullary cancer was performed by the German
Germans
The Germans are a Germanic ethnic group native to Central Europe. The English term Germans has referred to the German-speaking population of the Holy Roman Empire since the Late Middle Ages....

 surgeon Walther Kausch
Walther Kausch
Walther Kausch was a surgeon. He was involved in improvements made to the pancreaticoduodenectomy process.Walther Carl Eduard Kausch was the second of four children. He studied medicine at the Friedrich-Wilhelm-Universität in Strassburg from 1885 to 1890. He received his doctor's license on July...

 in 1909 and described by Kausch in 1912.

It is often called the Whipple procedure, after the American
People of the United States
The people of the United States, also known as simply Americans or American people, are the inhabitants or citizens of the United States. The United States is a multi-ethnic nation, home to people of different ethnic and national backgrounds...

 surgeon Allen Whipple
Allen Whipple
Allen Oldfather Whipple was an American surgeon who is known for the pancreatic cancer operation which bears his name as well as Whipple's triad....

 who devised an improved version of the surgery in 1935 and subsequently came up with multiple refinements to his technique.
The most common technique of a pancreaticoduodenectomy consists of the en bloc removal of the distal segment (antrum
Antrum
In biology, antrum is a general term for a cavity or chamber which may have specific meaning in reference to certain organs or sites in the body.In vertebrates, it may mean for example:...

) of the stomach
Stomach
The stomach is a muscular, hollow, dilated part of the alimentary canal which functions as an important organ of the digestive tract in some animals, including vertebrates, echinoderms, insects , and molluscs. It is involved in the second phase of digestion, following mastication .The stomach is...

; the first and second portions of the duodenum; the head of the pancreas; the common bile duct; and the gallbladder
Gallbladder
In vertebrates the gallbladder is a small organ that aids mainly in fat digestion and concentrates bile produced by the liver. In humans the loss of the gallbladder is usually easily tolerated....

.

The basic concept behind the pancreaticoduodenectomy is that the head of the pancreas and the duodenum share the same arterial blood supply (the gastroduodenal artery
Gastroduodenal artery
In anatomy, the gastroduodenal artery is a small blood vessel in the abdomen.It supplies blood directly to the pylorus and proximal part of the duodenum, and indirectly to the pancreatic head .It most commonly arises from the common hepatic artery of the celiac trunk, but there are...

).
 
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