D'Cruz Jason R., Misra Subhasis, Menon Gopal, Shamsudeen Shafeek
Mount Sinai- South Nassau
MVR Cancer Centre & Research Institute
Pancreaticoduodenectomy, commonly known as the Whipple procedure, is a complex and technically challenging surgery primarily used to treat malignancies in the pancreatic head, periampullary region, and distal bile duct. The procedure involves the resection of the pancreatic head and uncinate process, duodenum, proximal jejunum, distal bile duct, gallbladder, and usually part of the stomach, followed by restoring bilioenteric continuity (see Pancreaticoduodenectomy [Whipple Procedure]). While predominantly performed for malignant conditions, it is also indicated for benign conditions like chronic pancreatitis, large symptomatic cysts, or premalignant lesions such as intrapancreatic mucinous neoplasms. The procedure was first performed by Walter Kausch in Germany and later refined by Allen Whipple in the United States and has become a cornerstone in managing pancreatic and periampullary cancers. Advances in surgical techniques, including minimally invasive approaches like laparoscopy with or without robotic assistance, have improved outcomes, yet the Whipple procedure remains associated with significant morbidity and mortality. Successful outcomes hinge on meticulous patient selection, comprehensive preoperative preparation, skilled surgical and anesthetic techniques, and coordinated postoperative care.
胰十二指肠切除术，通常称为惠普尔手术，是一种复杂且技术要求高的手术，主要用于治疗胰头、壶腹周围区域和远端胆管的恶性肿瘤。该手术包括切除胰头和钩突、十二指肠、近端空肠、远端胆管、胆囊，通常还包括部分胃，然后恢复胆肠连续性（见胰十二指肠切除术[惠普尔手术]）。虽然主要用于治疗恶性疾病，但也适用于慢性胰腺炎、有症状的大囊肿或胰腺内黏液性肿瘤等癌前病变等良性疾病。该手术最初由德国的沃尔特·考施实施，后来由美国的艾伦·惠普尔改进，已成为治疗胰腺癌和壶腹周围癌的基石。手术技术的进步，包括有或没有机器人辅助的腹腔镜等微创方法，改善了治疗效果，但惠普尔手术仍然与显著的发病率和死亡率相关。成功的治疗效果取决于精心的患者选择、全面的术前准备、熟练的手术和麻醉技术以及协调的术后护理。
