[Complications following duodenohemipancreatectomy. Results of 112 patients 1974-1983].

From 1974 to 1983, 112 patients were treated at the Chirurgische Universitätsklinik Münster according to the procedure first published by Whipple in 1935. 40 patients (35.7%) were operated for chronic pancreatitis, 39 for (34.8%) ampullary cancer and 33 (29.5%) for pancreatic cancer. As to operative mortality which amounted to 10.7% (12/112) for all patients, figures of 10.0% (4/40) could be found for relapsing pancreatitis and 7.7% or 15.2% respectively for cancer patients. The underlying cause was circulatory arrest in 6 cases, anastomotic leakage in 4 cases, liver failure and gas gangrene in 1 case each. Altogether eight relaparotomies were performed (7.1%). As non-letal complications, pancreatic fistula, rise of liver enzymes, wound healing disturbances, and pleural effusion were the most frequent non-letal complications. By using the Ethibloc for pancreatic duct occlusion the rate of complications could be lowered. Hardly ever, glucose-metabolism was markedly affected by this extensive procedure.