This procedure is the treatment for the cancer of pancreatic head and ampulla.
Also known as a Whipple procedure, in pancreaticoduodenectomy, pancreas head grown due to a tumor in the pancreas or bile duct, or pancreatitis is removed. If a tumor exists in the head of the pancreas, it becomes necessary to remove the pancreatic head, gall-bladder, duodenum and a portion of bile duct. In some cases, a part of the stomach is also removed. To ensure flow of bile and enzymes into the intestines, the end of a patient’s bile duct and the remaining pancreas are connected to the small bowel.
A distal pancreatectomy is indicated for tumors in the body and tail of the pancreas in which removal of neoplasms is done. Surgeons attempt to preserve the spleen with both laparoscopic and open distal pancreatectomy procedures.


  • A dilated pancreatic duct usually reflects obstruction with chronic pancreatitis. Quite often, these patients present with stones in the pancreas.

Procedures to improve ductal drainage include:

Longitudinal Pancreaticojejunostomy (Puestow Procedure)

The pancreatic duct is attached to the small bowel after it is opened from the tail to the head of the pancreas.

Distal Pancreaticojejunostomy (Du Val Procedure)

The division of the pancreas is done transversely at the neck, and the body and tail are drained through an attachment to the small bowel.


In case of unsuccessful endoscopic sphincterotomy, surgical sphincteroplasty may be required of the minor or major papilla.