Whipple Procedure, Single Center Experience

Abstract: Whipple procedure (pancreaticoduodenectomy) is a complex operation to remove the head of pancreas, duodenum, gallbladder, and bile duct. The Whipple procedure is a difficult and demanding operation which serious complications such as pancreas anastomotic leak, therefore, mortality can occur. This study aimed to assess surgical outcomes, including morbidity and mortality rates, postoperative recovery, and specific procedural variables affecting patient outcomes. This was a prospective study. Patients with pre-existing pancreas and duodenum pathology were assigned to receive Whipple’s procedure from July 2019 to July 2021 at Prof Dr. R. D. Kandou Hospital. Male to female ratio, ages, preoperative biliary drainage (PBD), operation time, blood loss, mortality rate, and postoperative days (POD) were measured. The result showed that a total of 14 procedures were performed, with etiologies ranging from adenocarcinoma of pancreatic head (71.42%), duodenal GIST (7.14%), and NET (21.42%). Patient characteristics were male (50%), mean age 56 years. PBD was performed endoscopically with stent placement (50%), hepaticojejunostomy by pass (25%), and cholecystostomy (50%). Mean of operation time was 6 hours 20 minutes, estimated blood loss of 697.1 cc, pancreatic anastomosis leak (7.14%), no bile leaks, and other morbidities such as sepsis, wound infection, and ascites (14.28%). Mean of POD was nine days, and mortality rate at 21%. In conclusion, Whipple procedure is still a technically demanding procedure, and a better holistic care needs to be performed to reduce mortality and morbidity Keywords: Whipple procedure; postoperative care; pancreas; mortality rate