Whipple Procedure & Post Operative Bleeding Problems
The Whipple procedure, or pancreatoduodenectomy, is a surgery used to treat pancreatic cancer and in some instances small bowel cancer. The mortality rate for surgery is low with patients usually leaving the hospital after two weeks, but there is a risk of post operational bleeding and sepsis caused by the procedure.
What is the Whipple Procedure?
According to the Mayo Clinic, the Whipple procedure involves removing the head of the pancreas, a section of the bile duct, part of the small intestine and occasionally a section of the stomach. The surgeons then reconstruct the digestive track by hand. According to the Mayo Clinic, their surgeons perform more than 100 Whipple procedures every year.
Post-Surgical Bleeding
It is estimated that as many of 25 percent of the patients who undergo the Whipple procedure will have some sort of post-operative bleeding and or sepsis. The procedure creates a situation where there is the opportunity for massive hemorrhaging and arterial erosion. Complications from the Whipple procedure are the most common factor for mortality.
Early Bleeding
If the patient experiences bleeding within 24 hours of the surgery, it is most likely found at the intersection of two organs such as the pancreas and the intestine or the stomach. This is usually taken care of surgically by re-stitching the affected areas and draining the blood.
Later Bleeding
When the bleeding comes after the first 24 hours, the chances of death increase because the patient is already in a weakened state. The bleeding may come from an ulcer associated with an infection or abscess caused by leakage from the connection point of the organs. If the bleeding is coming from the surgical incision itself, it can easily be handled without surgery and antibiotics if there is an infection.
Treatment
The first treatment is to replace any blood that has been lost and to drain the blood from inside the abdomen. Embolization of the blood vessels to stop the bleeding is effective in about 80 percent of the patients, but follow-up surgery to take care of any internal infections may be required. Despite these complications, the Whipple procedure is still the preferred method of treating cancer of the pancreatic head.
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