Keywords
Digestive system neoplasms
Pancreaticoduodenectomy
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: Address the Whipple procedure, elucidating its indications, techniques, and prognosis. Literature review: Duodenopancreatectomy, also known as the Whipple procedure, is a highly complex technical procedure commonly used for the treatment of pancreatic and periampullary tumors. Originally, it involved the removal of the pancreas head, duodenum, the first 15cm of the jejunum, the common bile duct, and partial gastrectomy. However, advancements in diagnostic precision allow the procedure to be tailored to the patient's needs. Alongside this, technical refinement and the emergence of video and robotic surgical methods have led to a reduction in the original mortality rate from 40% to less than 5%. The indication for the procedure is primarily for cases of pancreatic neoplasia, biliary neoplasia, duodenal neoplasms, and severe chronic pancreatitis. Final considerations: Prognosis is associated with the location of the neoplasm, as well as the time from onset to diagnosis. Furthermore, patient survival quality is associated with the technical qualifications of the surgical and multidisciplinary team, showing significant disparities when performed in referral centers.
References
ABE S, et al. Advantage of endoscopic papillectomy for ampullary tumors as an alternative treatment for pancreatoduodenectomy. Sci Rep, 2022; 12: 15134.
AHN DH e BEKAII-SAAB T. Ampullary cancer: an overview. American Society of Clinical Oncology Educational Book, 2014; 34: 112–5.
AZIRET M, et al. Pancreatic gastrointestinal stromal tumor after upper gastrointestinal hemorrhage and performance of whipple procedure: a case report and literature review. American Journal of Case Reports, 2015; 16: 509–13.
BEUGNIEZ C, et al. Root-cause analysis of mortality after pancreatic resection (Care study): a multicenter cohort study. Ann Surg, 2021; 274: 789–96.
CASTILLO CF e JIMENEZ RE. Overview of surgery in the treatment of exocrine pancreatic cancer and prognosis. UpToDate, 2023.
CHANGAZI SH, et al. Whipple procedure: a five-year clinical experience in tertiary care center. Cureus, 2020; 12: 11466.
ENG NL, et al. Relationship between cancer diagnosis and complications following pancreatoduodenectomy for duodenal adenoma. Annals of Surgical Oncology, 2021; 28: 1097–105.
FERREIRA GM, et al. Cirurgia de Whipple: Indicação e Técnicas. Brazilian Journal of Implantology and Health Sciences, 2023; 5: 1604–15.
GUERRERO-MARTÍNEZ GA, et al. Laparoscopic pancreatoduodenectoy. Cir Cir, 2020; 88: 263–8.
HALBROOK CJ et al. Pancreatic cancer: Advances and challenges. 2023; 186(8): 1729-1754.
HELMINK BA, et al. Advances in the surgical management of resectable and borderline resectable pancreas cancer. Surg Oncol Clin N Am, 2016; 25: 287–310.
KARIM SAM, et al. The outcomes and complications of pancreaticoduodenectomy (Whipple procedure): Cross sectional study. Int J Surg, 2018; 52: 383–7.
KATO M, et al. Endoscopic resection of superficial non-ampullary duodenal epithelial tumor. DEN Open, 2022; 2: 54.
LIMA HKSS, et al. Adenocarcinoma de pâncreas - revisão de literatura. Revista Científica do Hospital e Maternidade José Martiniano Alencar, 2020; 2: 57–64.
LUCANDRI G, et al. Extended surgical resection for nonfunctioning duodenal neuroendocrine tumor. Journal of Surgical Case Reports, 2022; 9: 391.
LUU AM, et al. Long-term survival after pancreaticoduodenectomy in patients with ductal adenocarcinoma of the pancreatic head. Hepatobiliary Pancreat Dis Int, 2021; 20: 271–8.
MASIAK-SEGIT W, et al. Surgical treatment of pancreatic cancer. Pol Przegl Chir, 2018; 90: 45–53.
OUYANG L, et al. Robotic versus laparoscopic pancreaticoduodenectomy: an up-to-date system review and meta-analysis. Front Oncol, 2022; 12.
REBER HA, et al. Pylorus-preserving pancreaticoduodenectomy. UpToDate, 2023.
REBER HA. Surgical resection of lesions of the head of the pancreas. UpToDate, 2024.
SERRA F, et al. Short-term and long term morbidity in robotic pancreatic surgery: a systematic review. Gland Surg, 2021; 10: 1767–79.
SHYR BS, et al. Survival and surgical outcomes of robotic versus open pancreatoduodenectomy for ampullary cancer: A propensity score-matching comparison. Asian Journal of Surgery, 2024; 47: 899–904.
TORPHY RJ, et al. Pancreatic cancer treatment: better, but a long way to go. Surg Today, 2020; 50: 1117–25.
UIJTERWIJK BA, et al. The clinical implication of minimally invasive versus open pancreatoduodenectomy for non-pancreatic periampullary cancer: a systematic review and individual patient data meta-analysis. Langenbeck’s Archives of Surgery, 2023; 408: 311.
VAN RIJSSEN LB, et al. Variation in hospital mortality after pancreatoduodenectomy is related to failure to rescue rather than major complications: a nationwide audit. HPB (Oxford), 2018; 20: 759–67.
WU YZ, et al. Investigation of the factors influencing surgical treatment of duodenal gastrointestinal stromal tumors. World Journal of Gastrointestinal Oncology, 2021;13: 959–69.
ZHOU Y, et al. Surgery for duodenal gastrointestinal stromal tumor: A systematic review and meta-analysis of pancreaticoduodenectomy versus local resection. Asian Journal of Surgery, 2020; 43: 1–8.