Delhi: Rare Whipple surgery in pancreas saves pregnant woman's life

New Delhi, August 12

A six-month pregnant pancreatic cancer patient from Afghanistan got a new lease of life after a complex but successful Whipple surgery at the Fortis Hospital here, doctors at the facility said on Thursday.

This was one of the few Whipple surgeries conducted on pregnant women across the world, and probably “the first in India”, they said.

Dr Amit Javed, director of Gastrointestinal Oncology at Fortis Hospital, Vasant Kunj, said Fahima was five and a half months pregnant when she was diagnosed with pancreatic cancer.

The diagnosis was challenging as abdominal discomfort, nausea, and vomiting are common in pregnancy.

The common method used to diagnose pancreatic cancer is a CT scan of the abdomen, which is avoided in pregnancy as it is harmful to the foetus.

“Advanced pregnancy made the surgery challenging. In addition, she could not undergo chemotherapy on account of her pregnancy,” the hospital said in a statement.

Cancers developing in the body or the tail of the pancreas are removed by a distal pancreatectomy. Those localised at the head of the pancreas or arising from the lower bile duct, ampulla and second part of duodenum, are removed by a pancreaticoduodenectomy (also called a Whipple procedure).

The surgery in this situation was difficult and posed a potential risk for both the mother and the baby. Additionally, the uterus was quite large and obscured access to the pancreas, the hospital’s spokesperson said.

“This was a major operation which required us to adopt a multi-disciplinary approach. Advanced ICU capabilities, post-operative care units and high-level anaesthesia teams were all working in sync. The surgery took four hours,” Dr Javed said.

“We were able to perform it without ‘moving the baby’, and the post-operative tests showed complete tumour removal and a healthy baby,” he added.

Fahima had a smooth post-operative recovery and was discharged after seven days.

In a standard Whipple operation, doctors remove the cancerous tumour together with the head of the pancreas, a part of the stomach, small intestine, gall bladder, bile duct, and lymph nodes, and reattach the remaining organs (allowing for the normal digestion of food).

This was a complex procedure considering that the cancerous area (in the pancreas) and the uterus were very close to one another, the doctor said.

“Dr Javed and his team gave me hope. I will always be grateful and thankful to them for giving me a new lease of life and for saving my child,” Fahima said.

Dr Rajeev Nayyar, facility director at Fortis Hospital, said, “For the first time in India, a pregnant patient has undergone Whipple surgery successfully, and we are extremely proud of our doctors for the same.” — PTI