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. 2014 Oct;70(4):321-6.
doi: 10.1016/j.mjafi.2014.08.011. Epub 2014 Oct 8.

Whipple's pancreaticoduodenectomy: Outcomes at a tertiary care hospital

C K Jakhmola  1 , Ameet Kumar  2
Affiliations

Whipple's pancreaticoduodenectomy: Outcomes at a tertiary care hospital

C K Jakhmola et al. Med J Armed Forces India. 2014 Oct.

Abstract

Background: Pancreaticoduodenectomy is a formidable surgery and was associated with high morbidity and mortality. Though the mortality rates have steadily improved, morbidity continues to be high. There is lack of published data on outcomes following pancreaticoduodenectomy in Armed Forces hospitals. The aim of this study was to analyze the short term outcomes at our center and to compare it with the published literature.

Methods: A retrospective review of prospectively maintained data base was done. Preoperative, intraoperative and postoperative data was analyzed with emphasis on the morbidity and mortality rates. Follow up data was analyzed to look at disease recurrence.

Results: Between Jan 2008 and March 2014, 69 patients underwent Whipple's pancreaticoduodenectomy with a median age of 64 years. All had a malignant etiology with periampullary carcinoma being the commonest (42%). Overall, intra-abdominal complications occurred in 46% of patients which included postoperative pancreatic fistula (20%) and delayed gastric emptying (24%). The mortality rate for the whole was 11% which reduced to 8% in the second half of the study.

Conclusion: The short term outcomes at our center were comparable to those in published literature. The mortality rates showed a decreasing trend with time.

Keywords: Delayed gastric emptying; Morbidity; Mortality; Outcomes; Pancreaticoduodenectomy; Postoperative pancreatic fistula.

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Figures

Fig. 1
Fig. 1
A. Distribution of patients according to age groups. B. Histopathological diagnosis.
Fig. 2
Fig. 2
A. Various techniques of pancreaticojejunostomy used in the patients. B. Pancreatic fistula in the various techniques of pancreatic anastomosis done.
Fig. 3
Fig. 3
A. Indications for reoperation. B. Causes of mortality.
Fig. 4
Fig. 4
Recurrence pattern.
See this image and copyright information in PMC

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