HPB Oncology Center

Pancreatic Cancer & Whipple's Procedure

The pancreas is unforgiving, but not untreatable. Located deep in the abdomen, pancreatic cancer requires a surgeon with extreme precision. Whether it is a complex Whipple's Procedure for curative intent or palliative stenting for relief, Dr. Srinivas Bojanapu offers comprehensive, compassionate care backed by robotic technology.

Robotic Whipple's Biliary Stenting Multidisciplinary Board

Silent Symptoms & Diagnosis

The pancreas is a "silent" organ. Symptoms often appear only when the tumor presses on the bile duct or nerves.

Fig 1. Tumor location in the Pancreas Head vs Body/Tail determines the surgery type.

⚠️ Warning Signs

Painless Jaundice: Yellow eyes/skin without fever.
New Diabetes: Sudden sugar spikes in older adults.
Back Pain: Dull ache radiating from the stomach to the back.
Weight Loss: Unexplained drop in weight.

Diagnostic Protocol

We use a Triphasic CT Scan (Pancreatic Protocol) to check if the tumor is touching major blood vessels. An EUS (Endoscopic Ultrasound) helps us take a biopsy without cutting the skin.

The Whipple's Procedure

For tumors located in the "Head" of the pancreas, the Whipple's Procedure (Pancreaticoduodenectomy) is the only curative option. It is one of the most complex surgeries in the human body.

What We Remove & Reconnect:

Removal: The head of the pancreas, the gallbladder, the bile duct, part of the small intestine (duodenum), and sometimes part of the stomach.
Reconstruction: We carefully reconnect the remaining pancreas, bile duct, and stomach to the intestine so you can digest food normally.

The Robotic Advantage: Using the Da Vinci Xi Robot, we can sew these tiny connections with 10x magnification, reducing the risk of leaks and speeding up recovery.

Treatment Roadmap by Stage

Tumor Status	Description	Treatment Plan
Resectable	Clear of major arteries/veins.	Direct Surgery (Whipple's or Distal Pancreatectomy).
Borderline Resectable	Touching a major vein (Portal Vein).	Chemotherapy First (Neoadjuvant) to shrink tumor -> Then Surgery.
Locally Advanced	Encasing major arteries (SMA/Celiac).	Chemotherapy + Radiation. Surgery is rare.
Metastatic	Spread to Liver or Lungs.	Palliative Care: Stenting for jaundice, Nerve block for pain.

Palliative Care & Stenting

If surgery isn't possible, our focus shifts to Quality of Life. We ensure you are pain-free and able to eat.

Biliary Stenting (ERCP): If the tumor blocks the bile duct causing jaundice/itching, we place a metal or plastic stent endoscopically to open the flow.
Duodenal Stenting: If the tumor blocks food from leaving the stomach, a stent allows you to eat solid food again.
Celiac Plexus Block: A specialized injection to numb the nerves behind the pancreas, providing significant relief from back pain.

Common Questions

Can I live without a pancreas?

Yes. If the whole pancreas is removed, you will need to take enzyme capsules (like Creon) with every meal to digest food and Insulin injections to manage blood sugar. It is a manageable lifestyle.

How long is the recovery after Whipple's?

Hospital stay is typically 7-10 days. You start drinking liquids on Day 1. Full recovery takes about 6-8 weeks. Our ERAS protocols help speed this up significantly.

Is pancreatic cancer hereditary?

About 10% of cases are linked to genetics (BRCA2, Lynch Syndrome). If you have a strong family history, we recommend genetic counselling and screening for family members.

What is a pancreatic leak?

This is a risk after surgery where the connection between the pancreas and intestine doesn't heal perfectly. We monitor this closely. In most cases, it heals on its own with a temporary drain tube.