The purpose of this document is to ensure all Whipple specimens are described and dissected in a systematic/standardized way for proper diagnosis of duodenal, ampullary, and pancreatic disease. Please refer to local standard operating procedures (SOP) for complete details.
(NOTE: You can view 3D models in larger format by clicking on the "fullscreen" icon at the bottom right.)
Whipple specimen usually consists of the duodenum, distal stomach (+/- pylorus), the head of the pancreas and a part of the common bile duct. It may or may not have an attached gallbladder.
3D model provides an anatomic representation of a typical Whipple specimen (duodenum is opened along the anti-ampullary border)
Regions of interest for orientation and inking include:
Common bile duct margin
Pancreatic neck margin
Vascular groove
Uncinate margin (also referred to as SMA margin)
Posterior surface
Proximal duodenal (+/- stomach) margin
Distal duodenal margin
Major duodenal ampulla (ampulla of Vater)
Minor duodenal ampulla (ampulla of Santorini)
Anterior surface (typically contains abundant adipose tissue)
The Whipple specimen is inked according to SOP as follows:
Proximal duodenal (+/- stomach) margin - Purple (around staple line only for orientation)
Pancreatic neck margin - Blue
Vascular groove - Orange
Uncinate margin (SMA margin) - Green
Posterior surface - Black
Anterior surface - Yellow
(refer to the 3D model as an example)
The probe is inserted into the common bile duct (CBD) through to the major ampulla. If a stent is identified within the lumen, remove the stent prior to CBD opening. Cut open the CBD along the posterior surface of the specimen (typically contains the least amount of pancreatic tissue).
This 3D Whipple model demonstrates opened CBD with exposed pancreatic parenchyma.
For reference, ink code as above:
Pancreatic neck margin - Blue
Vascular groove - Orange
Uncinate margin (SMA margin) - Green
Posterior surface - Black