Early complications following pancreatico-duodenectomy

Objective: To determine the mortality and morbidity in patients after Whipple's pancreaticoduodenectomy. Design: Descriptive study. Place and suration of study: Department of General Surgery (Ward-2), Jinnah Postgraduate Medical Centre, Karachi. Patients and methods: All the patients who underwent standard Whipple's procedure were followed up during their hospital stay for early postoperative complication. The indicators for the development of complications included daily nasogastric (NG) tube output for delayed gastric emptying, ultrasound abdomen for intra-abdominal collections, presence of blood in drains and NG tubes for haemorrhage and measuring serum amylase for pancreatitis. Results: Out of 30 patients, 3 patients died in early postoperative period with 10% mortality while 26.67% had wound infection, 16.67% had chest complications, 13.34% developed intra-abdominal collections, 10% had haemorrhage, 3.34% had delayed gastric emptying, 3.34% had pancreatic fistula and 3.34% had organ failure. Conclusion: In this series the procedure was associated with decreased mortality due to increased experience and skills but morbidity was still high due to lack of facilities for the detection and management of postoperative complications. It should only be performed in tertiary care centres with expert surgical teams and facilities for adequate management of postoperative complications.