Surgical Outcomes of Pancreaticoduodenectomy (Whipple Procedure) in Pancreatic Head Cancer: A Single-Center Experience

Pancreaticoduodenectomy (Whipple procedure) remains the only potentially curative treatment for pancreatic head cancer, yet outcomes in resource-limited settings remain underexplored. This retrospective quantitative study was conducted at the Minar Cancer Center, Nishtar Hospital, Multan, and included 120 patients who underwent Whipple procedures between 2019 and 2023. Perioperative outcomes showed a mean operative time of 365 minutes, mean blood loss of 820 ml, mean hospital stay of 14.2 days, and a 30-day mortality rate of 5.0%. Nearly half of the patients (48.3%) developed at least one postoperative complication, with delayed gastric emptying (18.3%) and pancreatic fistula (15.0%) being most frequent, followed by wound infection, pulmonary complications, and hemorrhage. Statistical analysis revealed that older age, comorbidities, and advanced tumor stage were significantly associated with higher morbidity, while gender was not a predictor. Compared with international benchmarks, mortality rates were acceptable; however, morbidity rates remained high, reflecting the need for improved perioperative care pathways. This study concludes that Whipple procedures can be performed safely at a regional cancer center in South Punjab, though enhanced infection control, risk stratification, and implementation of Enhanced Recovery After Surgery (ERAS) protocols are essential to improve outcomes. The findings provide critical locally relevant data that can inform surgical practice, guide health policy, and contribute to national and global benchmarks for pancreatic cancer surgery.