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Pancreaticoduodenectomy: Past and Present

  • L. Andrew Shirley
  • Charles J. Yeo
Part of the M. D. Anderson Solid Tumor Oncology Series book series (MDA)

The surgical treatment of periampullary carcinoma has evolved greatly over the last 100 years, as has been summarized in several recent texts (1–3). The first reported successful resection of an ampullary carcinoma was performed by William S. Halsted at the Johns Hopkins Hospital in 1899 (Fig. 17.1). In a patient who presented with obstructive jaundice, he described a local, transduodenal approach to resection with reanastomosis of the pancreatic and bile ducts to the duodenum (4). Three months after the initial operation, the obstructive jaundice recurred, necessitating a re-exploration and cholecystoduodenostomy for decompression. The patient expired 6 months later and an autopsy revealed recurrence of the ampullary carcinoma into the head of the pancreas and duodenum.

This transduodenal approach to resection became the procedure of choice for most surgeons dealing with ampullary cancers in the early twentieth century. However, during this same time period, some surgeons were reporting the use of an en bloc pancreaticoduodenectomy for treatment of this disease. The first such resection was credited to Codivilla, but this patient did not survive the postoperative period ( 5 ). In 1912, Walther Carl Eduard Kausch, a German surgeon, performed the first successful two-stage pancreaticoduodenectomy (Fig. 17.2 ) ( 6 ). In the second stage of Kausch’s operation, he anastomosed the distal pancreatic remnant to the distal end of a partially resected duodenum. Two years later, Hirschel described the first one-stage pancreaticoduodenectomy, wherein he reimplanted the pancreatic duct into the duodenum, created a gastrojejunostomy, and connected the common bile duct to the duodenum using a rubber tube ( 7 ).

Keywords

Common Bile Duct Superior Mesenteric Artery Obstructive Jaundice Superior Mesenteric Vein Uncinate Process 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Schulick RD, Yeo CJ. 2002, Whipple procedure: 1935 to present. In: Evans DB, Pisters PWT, Abbruzzese JL (eds.) Pancreatic cancer. Springer-Verlag, New York, 125–138.CrossRefGoogle Scholar
  2. 2.
    Yeo CJ. 2001, Surgical management: standard Whipple procedure. In: Cameron JL (ed.) Atlas of clinical oncology: pancreatic cancer. BC Decker, Hamilton, ON, 99–108.Google Scholar
  3. 3.
    Yeo CJ, Cameron JL. 2000, The Johns Hopkins experience with pancreaticoduodenectomy for ductal adenocarcinoma of the pancreas. In: Dervenis CG, Bassi C (eds.) Pancreatic tumors: achievements and prospective. Thieme, Stuttgart, 176–188.Google Scholar
  4. 4.
    Halsted WS. 1899, Contributions to the surgery of the bile passages, especially of the common bile duct. Boston Med Surg J 141: 645–654.Google Scholar
  5. 5.
    Sauve L. 1908, Des pancreatectomies et specialement de la pancreatectome cephalique. Rev Chir 37:335–385.Google Scholar
  6. 6.
    Kausch W. 1912, Das carcinoma der papilla duodeni und seine radikale Entfeinung. Beitr Z Clin Chir 78:439–486.Google Scholar
  7. 7.
    Hirschel G. 1914, Die resecktion des duodenums mit der papille wegen karzinoims. Munchen Med Wochenscher 61:1728–1730.Google Scholar
  8. 8.
    Whipple AO, Parson WB, Mullins CR. 1935, Treatment of carcinoma of the ampulla of Vater. Ann Surg 102:763–779.CrossRefPubMedGoogle Scholar
  9. 9.
    Whipple AO. 1963, A reminiscence: pancreaticoduodenectomy. Rev Surg 20: 221–225.PubMedGoogle Scholar
  10. 10.
    Whipple AO. 1946, Observations on radical surgery for lesions of the pancreas. Surg Gynecol Obstet 82:623–631.Google Scholar
  11. 11.
    Brunschwig A. 1937, A one stage pancreaticoduodenectomy. Surg Gynecol Obstet 65:68–684.Google Scholar
  12. 12.
    Crile G Jr. 1970, The advantages of bypass operations over radical pancreaticoduodenectomy in the treatment of pancreatic carcinoma. Surg Gynecol Obstet 130: 1049–1053.PubMedGoogle Scholar
  13. 13.
    Shapiro TM. 1975, Adenocarcinoma of the pancreas: a statistical analysis of biliary bypass vs Whipple resection on good risk patients. Ann Surg 182:715–721.CrossRefPubMedGoogle Scholar
  14. 14.
    Howard JM. 1968, Pancreaticoduodenectomy: forty-one consecutive Whipple resections without an operative mortality. Ann Surg 168: 629–640.CrossRefPubMedGoogle Scholar
  15. 15.
    Braasch JW, Rossi RL, Watkins E Jr. 1986, Pyloric and gastric preserving pancreatic resection. Experience with 87 patients. Ann Surg 204:411–418.CrossRefPubMedGoogle Scholar
  16. 16.
    Crist DW, Sitzmann Cameron JL. 1987, I mproved hospital morbidity, mortality and survival after the Whipple procedure. Ann Surg 206: 358–365.CrossRefPubMedGoogle Scholar
  17. 17.
    Fernandez-del Castillo C, Rattner DW, Warshaw AL. 1995, Standards for pancreatic resection in the 1990’s. Arch Surg 130:295–300.PubMedGoogle Scholar
  18. 18.
    Yeo CJ, Cameron JL, Lillemoe KD, et al. 1995, Pancreaticoduodenectomy for cancer of the head of the pancreas: 201 patients. Ann Surg 221: 721–733.CrossRefPubMedGoogle Scholar
  19. 19.
    Trede M, Scwall G, Saeger H-D. 1990, Survival after pancreaticoduodenectomy: 118 consec-utive resections without an operative mortality. Ann Surg 221: 447–458.CrossRefGoogle Scholar
  20. 20.
    Cameron JL, Pitt A, Yeo CJ, et al. 1993, One hundred and forty five consecutive pancreati-coduodenectomies without mortality. Ann Surg 217:430–438.CrossRefPubMedGoogle Scholar
  21. 21.
    Yeo CJ, Cameron JL, Sohn TA, et al. 1997, Six hundred fifty consecutive pancreaticoduo-denectomies in the 1990’s: pathology, complications, outcomes. Ann Surg 226:248–260.CrossRefPubMedGoogle Scholar
  22. 22.
    Winter JM, Cameron JL, Campbell KA, et al. 2006, Pancreaticoduodenectomies for pancreatic cancer: a single institution experience. J GI Surg, 10:1199–1211.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • L. Andrew Shirley
    • 1
  • Charles J. Yeo
    • 1
  1. 1.Thomas Jefferson UniversityPhiladelphiaUSA

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