Postoperative Morbidity and Mortality Following Whipple’s Procedure for Solid Pseudopapillary Tumors: A Retrospective Study in Bangladesh

Abstract

Background: Solid pseudopapillary tumors (SPTs) of the pancreas are rare neoplasms presenting unique surgical challenges. The Whipple’s procedure remains pivotal in management, albeit with potential complications. Objective: To evaluate postoperative morbidity and mortality following the Whipple’s procedure for SPTs in Bangladesh, determining complication incidence, analyzing operative variables, and accurately identifying significant predictors of patient outcomes. Methods: A retrospective study was conducted from January 2018 to December 2023 at the Department of Hepatobiliary, Pancreatic & Liver Transplantation Surgery, Bangabandhu Sheikh Mujib Medical University, Al-Manar Hospital Ltd and Central Hospital Ltd, Dhaka. Thirty-five patients underwent the Whipple’s procedure for SPTs were retrospectively analyzed. Data on demographics, operative details, intraoperative blood loss, and postoperative complications were collected. Statistical analysis included calculation of means, standard deviations, and significance testing (p<0.05). Results: Among 35 patients (mean age 32 ± 8 years), the overall complication rate was 11.4% (n=4). Minor complications, such as delayed gastric emptying and wound infections, were noted, with major adverse event pancreatic fistula reported. The mean operative time was 360 ± 45 minutes, and the average intraoperative blood loss was 500 ± 120 mL. A statistically significant correlation was observed between prolonged operative time and increased postoperative morbidity (p=0.03). The average hospital stay was 12 ± 3 days, with perioperative improvements contributing to a 15% reduction in length of hospitalization compared to historical controls. Conclusions: The Whipple’s procedure for SPTs demonstrates acceptable morbidity with zero mortality. Strategic perioperative enhancements significantly reduce hospital stay, underscoring the procedure’s safety and efficacy in Bangladesh.