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Emergency Kausch-Whipple procedure: indications and experiences
Jens Standop1, Tim Glowka, Volker Schmitz
1Department of Surgery, University of Bonn Medical Center, Bonn, Germany. standop@uni-bonn.de
Pancreas
|February 26, 2010
Summary
Emergency pancreatoduodenectomy is rare but feasible in selected patients. Clinical decisions, not imaging, guide urgent pancreatic head resections, showing comparable mortality to elective procedures.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Pancreaticoduodenectomy (PD) is a complex surgical procedure.
- Emergency PD presents unique challenges compared to elective cases.
Purpose of the Study:
- To analyze the experience with urgent pancreaticoduodenectomies.
- To evaluate diagnostic methods and validate indications for emergency PD.
Main Methods:
- Review of a pancreatic resection database from 1989-2008.
- Identification of patients undergoing PD for emergency indications.
Main Results:
- Six patients (2%) underwent emergency PD.
- Indications included perforation, postoperative complications, and bleeding.
- Emergency PD showed increased length of stay and nonsurgical complications, but similar mortality and surgery-related complications compared to elective PD.
Conclusions:
- Indications for emergency PD are primarily clinical, not radiologic.
- Urgent pancreatic head resections can be a viable option for selected patients when conservative measures are insufficient.
