title: [54 consecutive duodenopancreatectomies without fatality].
abstract: Over a five-year period (1.1.89-31.12.93), a duodenopancreatectomy (Whipple's operation) was performed without hospital or 30-day death in 54 consecutive patients (22 women, 32 men; mean age 62 [27-82] years). The postoperative morbidity was 39% (21 of 54 patients). The indications for the operation were malignant tumour (n = 41), mainly ductal adenocarcinoma of the pancreas (n = 30), benign tumour (n = 5) or inflammatory head of the pancreas tumour in chronic pancreatitis (n = 6). A classical Whipple's operation was performed in 36 patients, while the stomach-preserving variant was undertaken in 18. The main complications were postoperative disorders of gastric emptying (n = 13), bleeding (n = 7), abscess (n = 4), leakage at the pancreas anastomosis (n = 3) and pancreatic fistula (n = 2). All complications were successfully overcome by early use of interventional methods or relaparotomy. -The low mortality rate of Whipple's operation (0-5% in selected centres) justifies the use of this operation even in advanced malignancies.
authors.affiliation: Klinik für Allgemeinchirurgie, Universität Marburg.
authors.forename: M
authors.initials: M
authors.lastname: Rothmund
authors.forename: R J
authors.initials: RJ
authors.lastname: Weinel
authors.forename: P K
authors.initials: PK
authors.lastname: Wagner
mesh_terms: D000038:Abscess / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005260:Female; D005746:Gastric Emptying; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010195:Pancreatitis / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D012086:Reoperation; D013272:Stomach Diseases / Q000209:etiology / Q000503:physiopathology
vernacular_title: 54 konsekutive Duodenopankreatektomien ohne Letalität.