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Computed tomography evaluation of early post-operative complications of the Whipple procedure

PURPOSE: Pancreaticoduodenectomy (the Whipple procedure) is the only potential curative treatment for periampullary tumours. Although mortality due to the procedure is gradually decreasing, the morbidity rates remain high. This study aimed to evaluate early computed tomography (CT) findings in patie...

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Autores principales: Emekli, Emre, Gündoğdu, Elif
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247017/
https://www.ncbi.nlm.nih.gov/pubmed/32467744
http://dx.doi.org/10.5114/pjr.2020.93399
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author Emekli, Emre
Gündoğdu, Elif
author_facet Emekli, Emre
Gündoğdu, Elif
author_sort Emekli, Emre
collection PubMed
description PURPOSE: Pancreaticoduodenectomy (the Whipple procedure) is the only potential curative treatment for periampullary tumours. Although mortality due to the procedure is gradually decreasing, the morbidity rates remain high. This study aimed to evaluate early computed tomography (CT) findings in patients suspected of complications following the Whipple procedure. MATERIAL AND METHODS: The CT images of patients who underwent the conventional Whipple procedure between January 2015 and January 2019 and underwent CT examination for the detection of early postoperative complications were retrospectively evaluated by two radiologists. RESULTS: The Whipple operation was performed to 65 patients, and the CT scans of 45 patients (30 males, 15 females) were included in the study. There were no complications in 21 patients. Complications were present in 24 patients (53.33%), of whom 13 had more than one complication. Eight patients had fluid collection in the operation site, two had haematoma, 10 had an abscess, and five had a pancreatic fistula. In addition, a hepatic abscess was detected in one patient, delayed gastric emptying in six patients, anastomotic leakage from the gastrojejunostomy line in two patients, superior mesenteric vein (SMV) thrombosis in two patients, and intraluminal haemorrhage and active extravasation in one patient. Mortality due to complications occurred in one patient in the early postoperative period. Other complications were treated by spontaneous, surgical or percutaneous interventional procedures. CONCLUSIONS: Despite the decreasing mortality rates in recent years, the Whipple procedure is risky and has high morbidity even when performed in experienced centres. CT is the adequate imaging modality for the evaluation of this anatomically altered region and detection of complications.
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spelling pubmed-72470172020-05-27 Computed tomography evaluation of early post-operative complications of the Whipple procedure Emekli, Emre Gündoğdu, Elif Pol J Radiol Original Paper PURPOSE: Pancreaticoduodenectomy (the Whipple procedure) is the only potential curative treatment for periampullary tumours. Although mortality due to the procedure is gradually decreasing, the morbidity rates remain high. This study aimed to evaluate early computed tomography (CT) findings in patients suspected of complications following the Whipple procedure. MATERIAL AND METHODS: The CT images of patients who underwent the conventional Whipple procedure between January 2015 and January 2019 and underwent CT examination for the detection of early postoperative complications were retrospectively evaluated by two radiologists. RESULTS: The Whipple operation was performed to 65 patients, and the CT scans of 45 patients (30 males, 15 females) were included in the study. There were no complications in 21 patients. Complications were present in 24 patients (53.33%), of whom 13 had more than one complication. Eight patients had fluid collection in the operation site, two had haematoma, 10 had an abscess, and five had a pancreatic fistula. In addition, a hepatic abscess was detected in one patient, delayed gastric emptying in six patients, anastomotic leakage from the gastrojejunostomy line in two patients, superior mesenteric vein (SMV) thrombosis in two patients, and intraluminal haemorrhage and active extravasation in one patient. Mortality due to complications occurred in one patient in the early postoperative period. Other complications were treated by spontaneous, surgical or percutaneous interventional procedures. CONCLUSIONS: Despite the decreasing mortality rates in recent years, the Whipple procedure is risky and has high morbidity even when performed in experienced centres. CT is the adequate imaging modality for the evaluation of this anatomically altered region and detection of complications. Termedia Publishing House 2020-02-19 /pmc/articles/PMC7247017/ /pubmed/32467744 http://dx.doi.org/10.5114/pjr.2020.93399 Text en Copyright © Polish Medical Society of Radiology 2020 https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0). License allowing third parties to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
spellingShingle Original Paper
Emekli, Emre
Gündoğdu, Elif
Computed tomography evaluation of early post-operative complications of the Whipple procedure
title Computed tomography evaluation of early post-operative complications of the Whipple procedure
title_full Computed tomography evaluation of early post-operative complications of the Whipple procedure
title_fullStr Computed tomography evaluation of early post-operative complications of the Whipple procedure
title_full_unstemmed Computed tomography evaluation of early post-operative complications of the Whipple procedure
title_short Computed tomography evaluation of early post-operative complications of the Whipple procedure
title_sort computed tomography evaluation of early post-operative complications of the whipple procedure
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247017/
https://www.ncbi.nlm.nih.gov/pubmed/32467744
http://dx.doi.org/10.5114/pjr.2020.93399
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