BACKGROUND: The aim of this study is to analyze 39 patients underwent Whipple's operation. METHOD: In the period from July 1998 to March 2004, thirty-nine patients underwent pancreaticoduodenectomy at University Hospital, Federal University of Maranhão. The diagnosis was made on the basis of computed tomography scan, ultrasound scan, Magnetic Resonance Imaging, and Endoscopic Retrograde Cholangiopancreatography. RESULTS: There were 22 male (56.4%) and 17 female (43.6%) and the mean age was 54.9 years (range 21-82 years).Definitive histology was available and showed periampullary adenocarcinoma in 35 patients (89.7%), chronic pancreatitis (3 patients - 7.7%), and colon adenocarcinoma (1 patient - 2.6%). The most common periampullary adenocarcinoma was pancreatic adenocarcinoma (27 patients - 69.2%), followed by ampullary (5 patients - 12.8%), duodenal carcinoma(2 patients - 5.1%), and distal bile duct (1 patient - 2.6%). The most common category of complication was pulmonary in five patients (12.8%), followed by intra-abdominal sepsis in four patients (10.2%), pancreatic anastomotic fistula in three patients (7.6%), and bleeding in three patients (7.6%). Overall 30-day in-hospital mortality in this series was 10.2 % (four patients). CONCLUSION: Pancreaticoduodenectomy continues to be associated with considerable morbidity. However, with careful patient selection, this procedure can be performed safely and with better outcome.
Pancreaticoduodenectomy; Common bile duct neoplasms; Ampulla of Vater
