A NOVEL MODIFICATION IN WHIPPLE’S PROCEDURE: GRAVITY EFFECT

Ogün Aydoğan^*, Erdem Barış Cartı, Ulaş Utku Şekerci

Adnan Menderes University Medical Faculty - Turkey

Introduction: Whipple procedure is the most common method for pancreatic head tumors. Even though the pancreatoduodenectomy-related mortality rate has dramatically decreased in the last 70 years, the morbidity rate remains around 40%. We aimed to investigate the results of an additional anastomosis to reduce post-pancreaticojejunostomy fistula development's  probability. To our knowledge, this modification was not described previously. 

Materials and methods: In 168 patients, we performed a standard Whipple procedure. We added an anastomosis to the pancreaticojejunostomy route in the remaining 38 patients. We evaluated these patients regarding early postoperative pancreatic fistula (POPF), complications and the early mortality rate.  

Results: The two groups were similar in demographic characteristics and comorbidities. No statistically significant difference was determined between the groups regarding POPF, bile leakage, and mortality rates. Thus, the additional anastomosis was determined not to prolong the operation's duration.  

Conclusions: We determined reduced POPF and mortality rates due to pancreatic stump anastomosis added to the Whipple procedure. Thus, in cases with a high leakage risk due to pancreatic tissue's soft nature or a narrow canal, this new anastomosis might reduce the probability of POPF development and related complications.