Abstract

We evaluated 53 patients who underwent Whipple operation at surgical department, Dong San Medical Center, Keimyung University during 5 years from Jan. 1989 to Dec, 1993. The results were as follows: The most prevalent age group was 50(20 cases) and male to female ratio was 2:l. Among 53 cases, 16 were ampulla of Vater cancers, followed by distal CBD cancer (12 cases), pancreatic head cancer(l 1 cases), duodenal cancer (7 cases), and others (7 cases). Fre- quent symptoms and physical findings were jaundice(66%), RUQ abdominal pain(64%), weight loss(50%), general weakness, fever, chill and indigestion. Abnormal laboratory findings were shown in bilirubin (36 cases), alkaline phosphatase (35 cases), CA 19-9 (21 cases), and CEA(12 cases), ERCP was superior than any other radiologic diagnostic tools such as C-T, U-S, PTC and UGI. Frequent postoperative complications were wound infection(8 cases), intraabdominal abscess (5 cases), anastomotic site leakage(4 cases), pleural e#ffusion, pneumonia (4 cases) and others. There was one case of postoperative mortality due to respiratory failure caused by massive transfusion for control of postoperative bleeding. Histologically pathologic invasion from distal CBD to pancreas occured in 9 cases, from ampulla of Vater to distal CBD in 5 cases, from pancreatic head to distal CBD in 3 cases. Survival was much higher in ampulla of Vater cancer (1 year survival 100%, 3 year survival 88%) than that of any other cancers of pancreaticoduodenal region.

• Keywords: Whipple operation, Cancer of pancreaticoduodenal region