Mr. Walker is now six months from his original diagnosis and his tumor has shrunk down to 2.4 x 1.2 cm on the HOP. Staging CT scans and PET scans do not demonstrate any evidence of metastatic disease. CA19-9 is now at 44 U/mL. Mr. Walker’s surgical oncologist has decided that he is a good candidate for a Whipple surgery. Mr. Walker is scheduled for the 16-hour surgery.
During the surgery, biliary liver diversion was completed, the head of the pancreas removed, and the remainder of the pancreas connected to the duodenum. A T-tube was in place to drain excess bile in the short term, jejunostomy tube (J-tube), and a JP drain was in place to manage abdominal fluid.
Post-operatively, Mr. Walker develops several complications: Paralytic ileus, absorption issues, vomiting, and dehydration. He remains on pancreatic enzymes and TPN until surgical wounds have healed and he is able to tolerate a soft diet