Diagram of Classical WhipplePancreatoduodenectomy is a formidable operation It involves removal of the head and uncinate process of the pancreas, the duodenum, the common bile duct and the gallbladder, with reconstruction by anastomosing the pancreatic remnant to the proximal jejunum or stomach, common hepatic duct to proximal jejunum and stomach or proximal duodenum to the jejunum.

The classical operation is called the Whipple resection, which includes removal of the distal stomach (gastric antrum and pylorus as well). These days we usually preserve the stomach and pylorus, the operation being called the pylorus-preserving proximal pancreatoduodenectomy (PPPPD).

This operation is done most commonly for tumours of the head and/or uncinate process of the pancreas or distal part of the common bile duct.

Less common reasons for doing this operation are tumours of the duodenum and chronic pancreatitis with an inflammatory mass involving the pancreatic head and uncinate process.



Dr Graham Stapleton is registered with the Health Professions Council of South Africa as a General Surgeon.

He specialises in liver and pancreatic surgery, with particular emphasis on removal of tumours of the liver and pancreas as well as other gastrointestinal cancers. He also supervises palliative treatments such as endoscopic and percutaneous stenting of obstructed bile ducts for those patients whose cancers are advanced and not resectable.

+27 (0) 21-6716181

+27 (0)82-569-4427

1406 Netcare Christian Barnard Memorial Hospital
Cnr DF Malan Street & Rua Bartholemeu Dias Plain
Foreshore, Cape Town, 8001