The article by Brown et al1 in a recent issue of the ARCHIVES is an excellent series of patients undergoing pancreaticoduodenectomy for ampullary cancer from an institution that has had substantial experience in performing the Whipple procedure. There was only 1 in-hospital postoperative death for an admirably low mortality of 2%. The pancreatic cutaneous fistula rate of 29% and the overall morbidity rate of 47% were high, but in these patients with normal textured glands and a small, normal pancreatic duct, theses figures are in line with other recent series.
Cameron JL. Pancreaticoduodenectomy Is Curative in the Majority of Patients With Node-Negative Ampullary Cancer. Arch Surg. 2005;140(7):708. doi:10.1001/archsurg.140.7.708