Pancreaticoduodenectomy: The Ibadan Experience
Ayandipo O.O
Department of Surgery, University College Hospital, Ibadan, Nigeria and Department of Surgery, College of Medicine, University of Ibadan, Nigeria.
Idowu O.K
Department of Anaesthesia, University College Hospital, College of Medicine, University of Ibadan, Nigeria.
Afolabi A.O
Department of Surgery, University College Hospital, Ibadan, Nigeria and Department of Surgery, College of Medicine, University of Ibadan, Nigeria.
Ajagbe O.A *
Department of Surgery, University College Hospital, Ibadan, Nigeria.
Adeleye J.O
Department of Medicine, University College Hospital, College of Medicine, University of Ibadan, Nigeria.
Fakoya A J
Department of Surgery, University College Hospital, Ibadan, Nigeria.
Dada O.E
Department of Surgery, University College Hospital, Ibadan, Nigeria.
Ilori O.T
Department of Surgery, University College Hospital, Ibadan, Nigeria.
Afuwape O.O
Department of Surgery, University College Hospital, Ibadan, Nigeria and Department of Surgery, College of Medicine, University of Ibadan, Nigeria.
Ogundiran T.O
Department of Surgery, University College Hospital, Ibadan, Nigeria and Department of Surgery, College of Medicine, University of Ibadan, Nigeria.
Irabor D.O
Department of Surgery, University College Hospital, Ibadan, Nigeria and Department of Surgery, College of Medicine, University of Ibadan, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Pancreaticoduodenectomy (PD), has become a procedure which has has evolved from a complex, staged operation with high morbidity and mortality to a routine single-session surgery.
Methods: This longitudinal descriptive study at the Surgical Department of University College Hospital Ibadan ran from March 2020 to March 2024. Data was obtained from the surgical records of the Surgery Department included clinicopathologic, peri and post-operative details, and morbidities. Analysis was with software SPSS 23.
Results: A total of 22 Whipple procedures were performed during this period. The commonest symptoms were weight loss (72.7%) and jaundice (63.6%). Most patients had performance status of Eastern Cooperative Oncology Group (ECOG). The mean duration of illness was 2.5 ± 1.1 months. Average operation time was 5.67 ± 1.29 hours, with mean blood loss of 672 ± 118 ml and mean hospital stay of 17.7 ± 18 days.
Three patients (13.6%) underwent the pylorus-sparing procedure, while two underwent total pancreatectomy (9.1%). Pancreatic fistula was the major postoperative complication, affecting two patients (9.1%), and six patients (27.3%) were admitted to the ICU. Commonest histological diagnosis was pancreatic adenocarcinoma.
Three patients (13.6%) died from multiple organ failure within the 30-day postoperative period. The mean follow-up duration was 7.8 ± 7.2 months.
Conclusion: We present our outcomes following this complex surgical technique in our resource-limited setting in sub-Saharan Africa.
Keywords: Pancreatic tumor, Whipples procedure, periampullary tumors, Ibadan, Whipple, pancreaticoduodenectomy, surgery, periampullary carcinoma