The History and Evolution of Pancreaticoduodenectomy

  • James F. Griffin
  • Christopher L. WolfgangEmail author


Pancreaticoduodenectomy (PD) is the procedure of choice for periampullary cancers, which include four separate malignancies occurring in the region of the ampulla of Vater: pancreatic ductal adenocarcinoma (PDAC), ampullary cancer, distal cholangiocarcinoma, and duodenal adenocarcinoma. The evolution of PD began as a series of isolated, independent resection attempts in the late 19th and early 20th centuries, but the procedure failed to gain momentum because of its great technical difficulty and dismal outcomes. Allen O. Whipple and colleagues were the first to adopt a systematic approach to radical pancreaticoduodenal resections and by 1935, they had demonstrated the technical feasibility of the procedure. However, the highly morbid operation was nearly abandoned altogether after postoperative outcomes failed to improve in the decades following Whipple’s initial success. Fortunately, a trend in centralization and standardization of care beginning in the 1980s fueled a decrease in perioperative mortality rates that now stands at 1-2% at high volume centers.


Pancreatic Fistula Pancreatic Ductal Adenocarcinoma Intraductal Papillary Mucinous Neoplasm Intraductal Papillary Mucinous Neoplasm Pancreatic Head Resection 
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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© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA

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