Whipple procedure: patient selection and special considerations

Abstract

At the inception of pancreatic surgery by Dr Whipple in 1930s, the mortality and morbidity risk was more than 20%. With further understanding of disease processes and improve ments in pancreas resection techniques, the mortality risk has decreased to less than 5%. Age and chronic illnesses are no longer a contraindication to surgical treatment. Life expectancy and quality of life at a later age have improved, making older patients more likely to receive pancreatic surgery, thereby also putting emphasis on operative patient selection to minimize complica tions. This review summarizes the benign and malignant illnesses that are treated with pancreas operations, and innovations and improvements in pancreatic surgery and perioperative care, and describes the careful selection process for patients who would benefit from an operation. These indications are not reserved only to Whipple operation, but to pancreatectomies as well.

Improving the Standard of Care for All—A Practical Guide to Developing a Center of Excellence

“…The first open pancreaticoduodenectomy was performed in 1935. The morbidity and mortality was more than 20% [ 5 ]. As technology and hospital systems improved, there was a decline in postoperative morbidity and mortality associated with pancreas surgery, which then allowed for other novel techniques to be applied to this discipline.…”