THE WHIPPLE RESECTION FOR CANCER IN US-DEPARTMENT-OF-VETERANS-AFFAIRS HOSPITALS

Objective The authors compiled the results after Whipple resection for cancer from a large U.S. national hospital system. Methods Computerized hospital and death benefits records for patients treated with Whipple resection for cancer from 1987 to 1991 in U.S. Department of Veterans Affairs hospitals were analyzed,. excluding lymphomas and neuroendocrine tumors. Institutional tumor registrar reports allowed TNM staging in 45% of these cancers. Results Whipple resections were performed in 252 patients with pancreatic cancer and 117 with other periampullary cancers. Complications occurred in 37%, and 30-day operative mortality was 8%. Postoperative sepsis was associated with a higher operative mortality rate. In patients with staged tumors, 5-year survivors were found only in those without lymph node involvement. Conclusions Whipple resection can cure cancer in or near the head of the pancreas when lymph nodes are not invaded by tumor. Complications occur in nearly 40% of patients, whereas operative mortality rate is related to the average age of the patient population.