What is the most common surgical complication following whipple procedure?
If disease mainly involves head of the pancreas, then pancreatico-duodenectomy can be done--Whipple's procedure.Whipple's operation is done by removing tumour with head and neck of pancreas, C loop of duodenum, 40% distal stomach, 10 cm proximal jejunum, lower end of the common bile duct, gallbladder, peripancreatic, pericholedochal, paraduodenal and perihepatic nodes. Continuity is maintained by choledochojejunostomy, pancreaticojejunostomy and gastrojejunostomy. Few advocate pancreaticogastrostomy into posterior wall of the stomach. Moality in Whipple's operation is 2-8%. Original Whipple's operation (1935) was two staged procedure- initial by pass and a second stage resection with closure of pancreatic stump. In 1941, Trimble performed one stage pancreaticojejunostomy. Complications are delayed gastric emptying (19%); pancreatic fistula (14%); infection (intraabdominal abscess, wound infection, cholangitis, pancreatitis, pneumonia); bile leak. Moality is 3%. ref:SRB&;S manual of surgery,ed 3,pg no 635
Disruption of pancreatic anastomosis
Biliary peritonitis
Disruption of gastric anastomosis
GI bleeding
G.I.T