Early complications following pancreatico-duodenectomy.
OBJECTIVE
To determine the mortality and morbidity in patients after Whipple's pancreaticoduodenectomy.


METHODS
Descriptive study.


METHODS
Department of General Surgery (Ward-2), Jinnah Postgraduate Medical Centre, Karachi.


METHODS
All the patients who underwent standard Whipple's procedure were followed up during their hospital stay for early postoperative complication. The indicators for the development of complications included daily nasogastric (NG) tube output for delayed gastric emptying, ultrasound abdomen for intra-abdominal collections, presence of blood in drains and NG tubes for haemorrhage and measuring serum amylase for pancreatitis.


RESULTS
Out of 30 patients, 3 patients died in early postoperative period with 10% mortality while 26.67% had wound infection, 16.67% had chest complications, 13.34% developed intra-abdominal collections, 10% had haemorrhage, 3.34% had delayed gastric emptying, 3.34% had pancreatic fistula and 3.34% had organ failure.


CONCLUSIONS
In this series the procedure was associated with decreased mortality due to increased experience and skills but morbidity was still high due to lack of facilities for the detection and management of postoperative complications. It should only be performed in tertiary care centres with expert surgical teams and facilities for adequate management of postoperative complications.
Aslam
Tahira
T
Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi. tahira_khans@yahoo.com
Masood
Rashid
R
Maher
Mumtaz
M
D006801:Humans; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000401:mortality*; D011183:Postoperative Complications / Q000209:etiology / Q000628:therapy; D013997:Time Factors