Whipple's procedure, distal pancreatectomy, laparoscopic and robotic pancreatic surgery for pancreatic cancer, cysts, and neuroendocrine tumours — performed by Dr. Srinivas Bojanapu (MBBS, MS, FACRSI, DrNB, PDF) at Kauvery Hospital, Electronic City, and Dhaara Liver Clinic, Yelahanka, Bengaluru.
The pancreas is a gland tucked behind the stomach, serving two critical functions: exocrine (producing digestive enzymes) and endocrine (producing insulin and glucagon to control blood sugar). Because of its location — nestled among the duodenum, bile duct, liver, and major blood vessels — pancreatic surgery is among the most technically demanding in abdominal surgery.
Conditions requiring pancreatic surgery include pancreatic cancer (ductal adenocarcinoma), neuroendocrine tumours (NETs), intraductal papillary mucinous neoplasms (IPMN), mucinous cystadenomas, and complications of chronic pancreatitis.
Painless jaundice (yellow skin/eyes), unexplained weight loss, new-onset diabetes after age 50, pale stools, and persistent upper abdominal or back pain are warning signs. Pancreatic cancer caught before it spreads is potentially curable — do not delay evaluation.
Removal of the pancreatic head, duodenum, gallbladder, and lower bile duct. Used for cancers of the pancreatic head, ampulla, and duodenum. Takes 4–6 hours; hospital stay 7–10 days.
Removal of the body and tail of the pancreas (left side). Used for body/tail tumours. The spleen may be preserved (SPDP) or removed depending on tumour proximity. Can be done laparoscopically.
Careful shelling-out of a small benign or low-grade malignant tumour (insulinoma, small NET) while preserving the surrounding pancreas. Minimal impact on pancreatic function.
Complete removal of the pancreas. Reserved for diffuse IPMN or multifocal tumours. Requires lifelong insulin and enzyme replacement.
Lateral pancreaticojejunostomy with core-out of the pancreatic head for pain relief in chronic pancreatitis with a dilated pancreatic duct.
Distal pancreatectomy and selected Whipple's procedures performed laparoscopically or with Da Vinci Xi robotic assistance for faster recovery in suitable candidates.
The Whipple's procedure (pancreaticoduodenectomy) is the definitive treatment for cancers of the pancreatic head:
| Phase | What Happens |
|---|---|
| Resection | Pancreatic head, duodenum, gallbladder, and lower bile duct are removed en bloc. |
| Vascular assessment | Superior mesenteric artery/vein and portal vein are carefully preserved. Involved vessels may require reconstruction. |
| Reconstruction (pancreaticojejunostomy) | Remaining pancreatic tail is connected to small intestine to drain enzymes. |
| Reconstruction (hepaticojejunostomy) | Bile duct is connected to small intestine to restore bile drainage. |
| Reconstruction (gastrojejunostomy) | Stomach is connected to small intestine to restore food passage. |
Surgery is the only potential cure for pancreatic cancer. Eligibility depends on:
Dr. Bojanapu reviews each case at a multidisciplinary tumour board at Kauvery Hospital before recommending the optimal treatment sequence — surgery, chemotherapy, or combined.
Dr. Srinivas Bojanapu holds DrNB (Surgical Gastroenterology) from Sir Ganga Ram Hospital, New Delhi — one of India's highest-volume HPB centres. He has published in peer-reviewed journals on pancreatic surgery including "Pancreas Transplantation Protocols" (Current Pancreatic Surgery, 2019). At Kauvery Hospital, Electronic City, he leads the HPB and GI oncology surgical team with access to robotic surgery, modern ICU, and dedicated oncology support.
Whipple's procedure (pancreaticoduodenectomy) removes the head of the pancreas, duodenum, gallbladder, and part of the bile duct. The remaining pancreas, bile duct, and stomach are reconnected to the small intestine. It is the standard curative surgery for pancreatic head cancer, ampullary cancer, and duodenal cancer. The operation takes 4–6 hours under general anaesthesia.
5-year survival after curative Whipple's for pancreatic ductal adenocarcinoma is 15–25%. For ampullary and duodenal cancers, 5-year survival is 40–60%. Outcomes are best at high-volume HPB centres and when complete (R0) resection is achieved. Early detection significantly improves prognosis.
A distal pancreatectomy removes the body and tail of the pancreas for cancers, cysts (IPMN, mucinous cystadenoma), and neuroendocrine tumours in the left side of the pancreas. The spleen may or may not be preserved. It can be performed laparoscopically or robotically in suitable cases, allowing faster recovery than open surgery.
Some pancreatic cysts carry malignant potential. IPMN (intraductal papillary mucinous neoplasm) and mucinous cystadenoma are pre-malignant lesions that require regular surveillance and, in selected cases, surgical removal. Serous cystadenomas are almost always benign. Dr. Bojanapu evaluates each cyst with CT, MRI/MRCP, and EUS to guide the decision.
For acute pancreatitis complications or urgent HPB emergencies:
📞 88846 94233