54 CONSECUTIVE DUODENOPANCREATECTOMIES WI THOUT DEATH

Over a five-year period (1.1.89-31.12.93), a duodenopancreatectomy (Wh ipple's operation) was performed without hospital or 30-day death in 5 4 consecutive patients (22 women, 32 men; mean age 62 [27-82] years). The postoperative morbidity was 39% (21 of 54 patients). The indicatio ns for the operation were malignant tumour (n = 41), mainly ductal ade nocarcinoma of the pancreas (n = 30), benign tumour (n = 5) or inflamm atory head of the pancreas tumour in chronic pancreatitis (n = 6). A c lassical Whipple's operation was performed in 36 patients, while the s tomach-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) a nd pancreatic fistula (n = 2). All complications were successfully ove rcome by early use of interventional methods or relaparotomy. - The lo w mortality rate of Whipple's operation (0-5% in selected centres) jus tifies the use of this operation even in advanced malignancies.