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HPB & Pancreatic OncologyAugust 2024Tertiary Surgical Unit
3D Laparoscopic Whipple with Pyloric Ring Resection for Ampullary Neoplasm
Clinical Outcome: Uneventful postoperative recovery. Oral sips started on Day 3, soft diet on Day 5. Zero delayed gastric emptying or pancreatic fistula.
SD
Operating Surgeon: Dr. Sudish Durgesh, MChConsultant Surgical Gastroenterologist • KMC Reg. 87559
Clinical Presentation & Pre-Op Summary
58yo male with progressive painless obstructive jaundice; successful 3D laparoscopic Whipple with pyloric ring resection and zero delayed gastric emptying.
Operative Details & Steps:
1. Complete diagnostic laparoscopy rule-out of peritoneal or hepatic metastasis.
2. Kocherization of duodenum and identification of superior mesenteric vein (SMV) and superior mesenteric artery (SMA).
3. Resection of head of pancreas and duodenum with complete lymphadenectomy. Resection of pyloric muscular ring.
4. Tri-staple vascular control. Reconstruction performed using modified Blumgart duct-to-mucosa pancreaticojejunostomy and end-to-side hepaticojejunostomy.
Postoperative Course & Functional Recovery:
Nasogastric tube removed on Day 1. Sips commenced on Day 3. Full soft diet tolerated on Day 5 with zero symptoms of delayed gastric emptying. Histopathology verified R0 negative margins with 19 negative nodes.
Have a Similar Complex Case?
Dr. Sudish Durgesh evaluates complex GI oncology, revision surgeries, and outstation cases with comprehensive multidisciplinary protocols.