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Whipple procedure: a review of a 7-year clinical experience in a referral center for hepatobiliary and pancreas diseases.
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- Additional Information
- Source:
Publisher: BioMed Central Country of Publication: England NLM ID: 101170544 Publication Model: Electronic Cited Medium: Internet ISSN: 1477-7819 (Electronic) Linking ISSN: 14777819 NLM ISO Abbreviation: World J Surg Oncol Subsets: MEDLINE
- Publication Information:
Original Publication: London : BioMed Central, 2003-
- Subject Terms:
- Abstract:
Background: Pancreatic cancer is generally found in the older population Pancreaticoduodenectomy seems to be the only way in resolving these resectable tumors. Allen. O Whipple was the first to describe pancreaticoduodenectomy in 1935 as a modified procedure. This article is a case series with respect to the 7-year experience of the Whipple procedure in Firoozgar Teaching Hospital.
Methods: Patient surgery details were gathered from the surgical records of the operating room and their clinical records from the hospital archives. Data was analyzed with SPSS software (version 16.0.1). Those patients, whose tumor had invaded the superior mesenteric artery, had extensive portal vein involvement or distant metastasis was considered as unresectable.
Results: The first Whipple procedure was recorded in our hospital in 2008. From 2008 till 20 March 2014, 70 cases were collected and analyzed. The mean age of cases was 58.4 years, the mean hospital stay length was 12.9 days (±6.23 days), mean operation time was 376 min (±37.3 min),. The most common presenting symptom was jaundice (78.6 %). Delayed gastric emptying was the most common post-operative complication. The most prevalent cause of reoperation was intra-abdominal abscess. Major morbidities of these patients consisted of cardiac arrhythmias (21.4%) and pneumonia (10%). Minor complications were wound infection (17.1%) and delayed gastric emptying (32.9%). The statistics revealed pancreatic anastomosis failure as 2.9% and a decrease in mortality rate from 50% during the first years of this study to 16% to 20% during the last years.
Conclusions: In this case series, the time of operation decreased during the recent years .Analysis shows a correlation between operation time and pack cell transfused during the operation, but no correlation was found between operation time and post-operation hospitalization course. It is true that hospital setting, socioeconomic level of the patients including their compliance, and the expertise of the surgeons and surgical staff can have an influence on the result of this operation, but it seems that the magnitude of the surgical stress of this procedure and the (compromised) functional reserve of this patient population can be a notable factor influencing the outcome.
- References:
N Engl J Med. 2002 Apr 11;346(15):1128-37. (PMID: 11948273)
Eur J Surg Oncol. 2011 Sep;37(9):798-804. (PMID: 21767928)
N Engl J Med. 2010 Apr 29;362(17):1605-17. (PMID: 20427809)
Ann Surg. 1945 Jun;121(6):847-52. (PMID: 17858621)
Ann Surg. 2000 Jun;231(6):890-8. (PMID: 10816633)
Lancet. 2004 Mar 27;363(9414):1049-57. (PMID: 15051286)
Arch Surg. 2009 Dec;144(12):1179-84. (PMID: 20026839)
Ann Surg. 1999 May;229(5):613-22; discussion 622-4. (PMID: 10235519)
Int J Clin Exp Pathol. 2008 Jan 01;1(4):306-16. (PMID: 18787611)
J Cell Biochem. 2007 Jul 1;101(4):887-907. (PMID: 17266048)
Ann Surg. 2008 Jan;247(1):191-202. (PMID: 18156940)
CA Cancer J Clin. 2008 Mar-Apr;58(2):71-96. (PMID: 18287387)
Surgery. 2012 Sep;152(3 Suppl 1):S56-63. (PMID: 22770961)
Arch Pathol Lab Med. 2009 Mar;133(3):365-74. (PMID: 19260742)
- Publication Date:
Date Created: 20150418 Date Completed: 20160405 Latest Revision: 20220408
- Publication Date:
20231215
- Accession Number:
PMC4363458
- Accession Number:
10.1186/s12957-015-0523-8
- Accession Number:
25885408
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