The current status of the Whipple procedure for ampullary and periampullary carcinoma

Between 1980 and 1994, 22 patients underwent Whipple operation for ductal adenocarcinoma of the head of the pancreas and adenocarcinoma of the papilla of Vater at the 1st Department of Surgery, University of Rome 'La Sapienza'. All resections were performed by the same surgical equipe. Preoperative biliary drainage was performed in 14 patients with severe jaundice. There was no mortality related to the adopted procedure. Two patients presented moderate postoperative complications: leakage of the pancreatojejunostomy and lymphorrea which were resolved in about 2 weeks. One patient died in the postoperative course because of severe hepatorenal failure due to previous biliary cirrhosis and cholangitis. Our data agree with recent literature reports and show that Whipple operation or its variants still constitute a valid choice in the treatment of tumors of the head of the pancreas and of the papilla of Vater.