Whipple's operation is an extensive operation used as an attempt at a cure for pancreatic carcinoma or cholangiocarcinoma, when lesions are extrahepatic and periampullary, and occasionally, for chronic pancreatitis.
It involves resection of most of the extrahepatic biliary system, the whole of the duodenum, the distal stomach and the head of the pancreas. Anastomoses are then formed between the remaining structures; for example, the tail of the pancreas to the jejunal stump and the bile duct to the side of the jejunum.
Whipple's operation is only appropriate in a very select group of patients with pancreatic cancer; factors include fitness, age and absence of metastases. Careful selection leaves about 10% of patients in whom surgery may improve prognosis, of which at best only 20% may survive to five years.
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