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Twenty-five Consecutive Whipple Procedures
in a Community Setting
by
Joseph N. Michelotti, M.D., M.A., F.A.C.S.
Operative mortality: 0.0% Long term cure rate: 28% Length of stay: 8.5 days
| OR | Blood | Hosp | Pathology | |||||||||||||
| Presenting | Pre-Op | Whipple | Time | Loss | PostOp | Stay | Nodes | F/U | Death | Other | ||||||
| Pt # | Age | Sex | Symptoms | Diag | Modification | (hrs) | (ml) | Complication | (da) | Primary | Grade | Size | Pos | (mo) | (mo) | Info |
| 1 | 62 | M | Jaundice | Cancer | Ca Ampulla | 0.5 | 3 | 21 | died w mets | |||||||
| 2 | 66 | M | Jaundice | None | 13 | Ca Pancreas | 3.0 | 3 | 5 | died w liv mets | ||||||
| 3 | 68 | M | Wt Loss Jaundice | Cancer Ampulla | Pylorus spare | 2400 | None | 7 | Ca Ampulla | 2 | 2.5 | 0 | 23 | died w liv mets | ||
| 4 | 60 | F | Wt Loss Pain | Cancer Pancreas | Pylorus spare, Total pancreatectomy | 13 | 1200 | None | Ca Pancreas | 0 | 16 | |||||
| 5 | 62 | M | Wt Loss Jaundice | Cancer | Total pancreatectomy | Colitis, GI Bl | 25 | Ca Pancreas | "3-4" | 4.1 | 0 | 3 | died w liv mets | |||
| 6 | 69 | M | Pain | Pancreas | Pylorus spare | 10 | 600 | None | 7 | Ca Ampulla | 2 | 4.0 | 1 | 14 | IORT, died w recur | |
| 7 | 67 | M | Pain | Cancer Pancreas | Pylorus spare | None | 9 | Hamartoma | 0.6 | 0 | 209 | died w colon ca | ||||
| 8 | 78 | F | Jaundice | Stone disease | Pylorus spare | 8.5 | 500 | None | 8 | Ca Ampulla | 2 | 2.6 | 2 | 8 | recur | |
| 9 | 67 | F | Wt Loss Pain | Pancreas | Pylorus spare, Total pancreatectomy | 800 | Pylorospasm | 7 | Ca Pancreas | 3 | 2.6 | 0 | 6 | died w mes emb | ||
| 10 | 67 | F | Wt Loss Jaundice | Pylorus spare | None | Ca Pancreas | "2-3" | 5.0 | "yes" | 9 | liv mets at fu | |||||
| 11 | 74 | F | Wt Loss Jaundice | Biopsy Neg | Pylorus spare | 10 | 1000 | None | Ca PeriAmp | "2-3" | 2.0 | 7 | 12 | pancreatitis, bile peritonitis | ||
| 12 | 32 | M | Cancer Duodenum | Pylorus spare, IVC node dissection | 15 | 1000 | None | 7 | Ca GermCell | 9.5 | 4 | 63 | No disease | |||
| 13 | 78 | M | Wt Loss Jaundice | Cancer | Pylorus spare, Total pancreatectomy | 10 | 0 | None | Ca Pancreas | 2 | "diffuse" | "multiple" | 6 | mets | ||
| 14 | 75 | M | Jaundice | Cancer Common Duct | Pylorus spare | 8 | 600 | None | 10 | Ca Common Duct | 2 | 2.5 | 4 | 137 | No disease | |
| 15 | 60 | M | Jaundice | Cancer | Pylorus spare | 12 | 1500 | Biloma | 18 | Ca Pancreas | "3-4" | 3.2 | 0 | 2 | ||
| 16 | 51 | M | Wt Loss Jaundice Pain | Biopsy Neg | Pylorus spare | None | 7 | Ca Pancreas | "2-3" | 4.5 | 2 | 22 | died w liv mets | |||
| 17 | 67 | F | Jaundice Pain | Cancer Duodenum | Fistula | 7 | Ca Duodenum | "2-3" | 4.8 | 0 | 156 | ca aff limb BII | ||||
| 18 | 75 | M | Wt Loss Jaundice | Cancer | Pylorus spare, cystostomy | 8 | 1200 | Biloma, Pylorospasm | 28 | Ca Common Duct | "2-3" | 1.6 | 0 | 14 | No disease | |
| 19 | 84 | F | Jaundice | Cancer | Pylorus spare | 12 | 800 | None | 7 | Ca Pancreas | "2-3" | 3.8 | 0 | 3 | micro pos marg | |
| 20 | 36 | M | Pain | Biopsy Neg | sp duct cyst surg | 14 | 800 | Pneumonia | 13 | Ca Common Duct | 2 | 3.0 | 0 | 52 | murdered | |
| 21 | 76 | M | Jaundice | Cancer | Pylorus spare | 850 | Pylorospasm | 18 | Ca Common Duct | "1-2" | "diffuse" | 0 | 120 | No disease | ||
| 22 | 71 | F | Pain | Cancer Common Duct | Pylorus spare | None | 7 | Ca Common Duct | 0.3 | 0 | 60 | No disease | ||||
| 23 | 55 | M | Wt Loss Pain | Cancer Duodenum | Total pancreatectomy | None | 12 | Ca Duodenum | "1-2" | 3.0 | 0 | 3 | No disease, died w empyema, ca rectum | |||
| 24 | 69 | M | Wt Loss Jaundice | Cancer | Pylorus spare | 5 | 600 | Stroke | 12 | Ca Pancreas | 2 | 2.5 | 0 | 2 | DNR, died w gi bleed | |
| 25 | 56 | M | Jaundice | Cancer Ampulla | Pylorus spare | 12 | 500 | None | 7 | Ca Ampulla | "2-3" | 4.0 | 4 | 6 | died w liv mets | |