Whipple’s pancreaticoduodenectomy at a resource-poor,low-volume center in Trinidad and Tobago

作     者：Shamir O Cawich Dexter A Thomas Neil W Pearce Vijay Naraynsingh 

作者机构：Department of SurgeryPort of Spain General HospitalPort of Spain 000000Trinidad and Tobago Department of SurgerySouthampton General Hospital National Health Services TrustSouthampton SO166YDUnited Kingdom 

出 版 物：《World Journal of Clinical Oncology》 (世界临床肿瘤学杂志（英文版）)

年 卷 期：2022年第13卷第9期

页      面：738-747页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Pancreas Surgery Pancreatectomy Whipple’s Pancreaticoduodenectomy 

摘      要：BACKGROUND Many authorities advocate for Whipple’s procedures to be performed in highvolume centers,but many patients in poor developing nations cannot access these *** sought to determine whether clinical outcomes were acceptable when Whipple’s procedures were performed in a low-volume,resource-poor setting in the West *** To study outcomes of Whipple’s procedures in a pancreatic unit in the West Indies over an eight-year period from June 1,2013 to June 30,*** This was a retrospective study of all patients undergoing Whipple’s procedures in a pancreatic unit in the West Indies over an eight-year period from June 1,2013 to June 30,*** This center performed an average of 11.25 procedures per *** were 72 patients in the final study population at a mean age of 60.2 years,with 52.7%having American Society of Anesthesiologists scores≥III and 54.1%with Eastern Cooperative Oncology Group scores≥*** Whipple’s procedures were performed in 70 patients and laparoscopic assisted procedures in *** vein resection/reconstruction was performed in 19(26.4%)*** patients undergoing open procedures there was 367±54.1 min mean operating time,1394±656.8 mL mean blood loss,5.24±7.22 d mean intensive care unit stay and 15.1±9.53 d ***(8.3%)patients experienced minor morbidity,10(14%)major morbidity and there were 4(5.5%)*** This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring Whipple’s *** volume centers in resource poor nations can achieve good short-term *** is largely due to the process of continuous,adaptive learning by the entire hospital.