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Original Article
 
Whipple's procedure: Yesterday and today
Brajesh B. Gupta1, Amit Narayan Bellurkar2, Sanjay S. Changole3, Vishal R Nandagawli4, Girish Umare4
1MS, Professor, Department of surgery government medical College Hospital Nagpur Maharashtra India.
2M.S. (STD), Resident, Department of surgery government medical College Hospital Nagpur Maharashtra India.
3MS, Associate Professor Department of surgery government medical College Hospital Nagpur Maharashtra India.
4MS, Assistant Professor Department of surgery government medical College Hospital Nagpur Maharashtra India.

Article ID: 100045IJHPDBG2016
doi: 10.5348/ijhpd-2016-45-OA-1

Address correspondence to:
Dr. Brajesh B. Gupta
A-5, Corporation Colony
Nagpur 440033
Maharashtra
India

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How to cite this article
Gupta BB, Bellurkar AN, Changole SS, Nandagawli VR, Umare G. Whipple's procedure: Yesterday and today. Int J Hepatobiliary Pancreat Dis 2016;3:1–5.


Abstract
Aims: This article is a case series with respect to the four year experience of Whipple's procedure at Government Medical College and Hospital Nagpur. In this study, we have studied the demographic details of the patients, various indications for Whipple's procedure, the co-factors which affect the procedure its outcome and causes of morbidity and mortality among operated patients.
Methods: This study was performed by collecting data about patients undergoing Whipple's procedure from operation theatres and medical record section. Those patients, whose tumor was unresectable and undergone palliative surgical procedures were excluded from the study.
Results: From May 2011 till May 2015, 51 cases were collected and analyzed. Adenocarcinoma pancreas was the most common indication for the procedure. 18 out of 33 patients presented with jaundice had undergone preoperative biliary stenting. Mean operation time was less in patients in whom ultrasonic scalpel was used and who had not undergone preoperative stenting. The most prevalent cause of reoperation was hemorrhage. Major postoperative morbidity of these patients was due to pneumonia (23.4%). Minor post-operative complications were wound infection and delayed gastric emptying.
Conclusion: In this study, we have concluded that usage of ultrasonic scalpel, avoidance of preoperative stenting experience of surgeon and supporting staff has led to decrease in operative duration and blood loss. Pulmonary complications and septicemia secondary to anastomotic leakage are the most common causes of morbidity and mortality.

Keywords: Biliary stenting, Pancreatic cancer, Periampullary carcinoma, Whipple procedure


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Author Contributions:
Brajesh B. Gupta – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Amit Narayan Bellurkar – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Vishal R. Nandagawli – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Girish M. Umare – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Sanjay S. Changole – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2016 Brajesh B. Gupta et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.