Prognostic Indicators for Morbidity after Pancreaticoduodenectomy
Introduction
A Pancreaticoduodenectomy is a complex surgical procedure, performed to remove a neoplasm from the head of the pancreas and also to resect neoplasms from the duodenum and common bile duct (Rios et al, 1999). The procedure classically involves the removal of the head of the pancreas, the duodenum, some proximal jejunum, the gallbladder, the common bile duct to just above the cystic duct and the distal stomach. However sometimes the distal stomach is preserved in what is know as a pylorus-preserving pancreaticoduodenectomy. The operation results in three new anastomoses: a pancreaticojejunostomy, a gastrojejunostomy and a hepaticojejunostomy. The reasoning behind such a large en bloc removal of viscera is mainly due to the shared blood supply of the duodenum and head of pancreas, the gastroduodenal artery (Chandrakanth et al, 2010).
The procedure was first described in 1898 by Italian surgeon Alessandro Codivilla and it was first used for peri-ampullary cancer by German surgeon Walther Kausch in 1909. It was in 1935 that Dr. Allen Whipple, a surgeon in New York, improved the procedure and it is after him the procedure is nicknamed today, as the pancreaticoduodenectomy is more commonly known as the Whipple procedure.
This retrospective study aims to investigate, by obtaining information from patient charts, if it is possible to predict post-Whipple morbidity using a patient’s details, including their pre-Whipple medical and surgical history, blood measurements and social history.
Methods
Data Acquisition:
A list of patients was drafted, all of whom had undergone a Whipple procedure at St. Vincent’s University Hospital, Dublin (SVUH) and St. Vincent’s...
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...longer hospital stay and thus an increased risk of other complications.
Conclusion
The results of this study highlight some subtle indicators for morbidity post-Whipple procedure. The link between cigarettes and post-op RTI is significant and it is worth investigating whether, hypothetically, patients with a smoking history should be placed on prophylactic antibiotics post-operatively. Reducing the occurrence of such a common complication can reduce mortality risk, healthcare staff working hours and ultimately save healthcare system money.
Works Cited
1. Rios G, Conrad A, Cole D, Adams D, Leveen M, O'Brien P, Baron P. (1999)
Trends in indications and outcomes in the Whipple procedure over a 40-year period.
2. Chandrakanth Are, Mashaal Dhir, Lavanya Ravipati. (2010)
History of pancreaticoduodenectomy: early misconceptions, initial milestones and the pioneers.
Popular television paint a glorified image of doctors removing the seriousness of medical procedures. In the non-fiction short story, “The First Appendectomy,” William Nolen primarily aims to persuade the reader that real surgery is full of stress and high stakes decisions rather than this unrealistic view portrayed by movies.
...h a type of surgery called Cholecystectomy. The Non-Surgical approaches are used only in specific situations such as when a patient’s condition prevents using an anesthetic. In such cases, Oral dissolution therapy is used.
Thompson, P. M., Vidal, C., Giedd, J. N., Gochman, P., Blumenthal, J., Nicolson, R., Toga, A. W., &
Sclauser Pessoa, I. B., Costa, D., Velloso, M., Mancuzo, E., Reis, M. S., & Parreira, V.F.
Forsyth, K., Taylor, R., Kramer, J., Prior, S., Richie, L., Whitehead, J., Owen, C., & Melton, M.
Ed. Larry Madaras and James M. Sorelle.
Cox-Foster, D. L., Conlan, S., Holmes, E. C., Palacios, G., Evans, J. D., Moran, N. A.,…
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