These are record figures in our environment both in terms of the number of operations performed by a single centre and, even more importantly, in terms of qualitative results, as the high complexity of the intervention makes it very difficult to achieve zero mortality for a whole year.
Cephalic duodenopancreatectomy or Whipple surgery is mainly indicated to treat tumours located in the pancreatic head. It consists of removal of the pancreatic head, duodenum, gallbladder and extrahepatic bile duct, followed by subsequent restoration of pancreatic, biliary and digestive continuity.
Given its complexity, it needs to be performed in centres with a high volume and experience. It is recommended that centres perform at least 20 interventions per year and are staffed by a multidisciplinary team with expertise in this procedure. The Catalan Health Service has been promoting, for some years now, the concentration of this type of intervention in a few expert centres. Across Catalonia, a total of 215 cephalic duodenopancreatectomies were performed in 2021. The morbidity (complication rate) of this surgery is around 50%, and the postoperative mortality in expert and reference centres is below 5%.
The success of Bellvitge Hospital’s Pancreatic Surgery Unit can be attributed to several crucial factors, as revealed by its members. Notably, the team underscores the significance of experience, technique standardisation, meticulous patient selection during the radiological stage, and the implementation of the ERAS protocol for enhanced post-surgery recovery. Nursing, playing a pivotal role in this process, further contributes to the unit's remarkable success.