Pancreaticoduodenectomy: Techniques and controversies

Pancreaticoduodenectomy, commonly known as the Whipple operation, is a procedure performed for patients with tumours in the pancreatic head. Although, with improvement in surgical techniques & perioperative management, the mortality associated with the operation has reduced from 15% to less than 5% over the years, the morbidity still remains at about 30%-40% mainly due to leaks from the anastomosis between the residual pancreas and the gut. There have been different strategies devised to reduce these complications and improve the results of the standard Whipple procedure and we will be discussing the published evidence regarding their benefits in this article.