[54 consecutive duodenopancreatectomies without fatality]

Over a five-year period (1.1.89-31.12.93), a duodenopancreatectomy (Whipple's operation) was performed without hospital or 30-day death in 54 consecutive patients (22 women, 32 men; mean age 62 [27-82] years). The postoperative morbidity was 39% (21 of 54 patients). The indications for the operation were malignant tumour (n = 41), mainly ductal adenocarcinoma of the pancreas (n = 30), benign tumour (n = 5) or inflammatory head of the pancreas tumour in chronic pancreatitis (n = 6). A classical Whipple's operation was performed in 36 patients, while the stomach-preserving variant was undertaken in 18. The main complications were postoperative disorders of gastric emptying (n = 13), bleeding (n = 7), abscess (n = 4), leakage at the pancreas anastomosis (n = 3) and pancreatic fistula (n = 2). All complications were successfully overcome by early use of interventional methods or relaparotomy. -The low mortality rate of Whipple's operation (0-5% in selected centres) justifies the use of this operation even in advanced malignancies.