The Outcome of Patients with Different Pancreatic Tumors Treated by Whipple’s Operation at Bangabandhu Sheikh Mujib Medical University

Background: Whipple’s Operation was first introduced by Allan Whipple in the 1930s. During 1960s and 1970’s the mortality rate for the Whipple operation was very high. Pancreatic tumors are one of the important indications for Whipple’s operation. About 85% of patients had adenocarcinoma tumor of the pancreas. 15% of patients had other tumors in the head region. In the Whipple’s operation the head of the pancreas, a portion of the bile duct, the gallbladder and the duodenum is removed. The aim of the study was to find the outcome of patients with different benign and malignant pancreatic tumor who undergone Whipple’s surgery and compare the preoperative finding and postoperative complication.Material & Methods:This study was a cross-sectional observational study which was carried out at the Department of Hepatobiliary and Pancreatic Surgery in Bangabandhu Sheikh Mujib Medical University (B.S.M.M.U), Dhaka, Bangladesh. The study was conducted during the period of August 2010 to July 2012. There were a total of 20 cases.Results:100% having solid pseudo papillary tumor age below 35yrs. After Whipple’s operation for solid pseudo papillary tumor of the pancreas, or benign tumor group, 25% of patients had developed wound infection. But in the case of Whipple’s operation for adenocarcinoma pancreas, 62.25% of patients developed wound infection. At a follow-up after 1 year of Whipple’s surgery, none of the benign tumor cases needed readmission, as all 100% had normal liver function tests, normal levels of CA 19-9, and normal USG findings in the abdomen. On the other hand, 25% of the malignant tumor cases had some form of complication and needed readmission.Conclusion:Most pancreatic tumors were located in the head of the pancreas which can be treated by Whipple’s operation. Adenocarcinoma of the head is the most common indication of surgery and is surgically resect able.

Tuberculosis of the Common Bile Duct: Rare Cause of Obstructive Jaundice

Tuberculosis (TB) is a very rare cause of biliary stricture that isdifficult to diagnose and usually requires surgical interventionin order to rule out underlying malignant etiology. A 48-yearsold man with obstructive jaundice, who was originally thoughtto have cholangio-carcinoma. He underwent repeatedtreatments with endoscopic biliary drainage (EBD) andreceived two schedule of chemotherapy, was finally proved tohave tuberculosis of the common bile duct with adjacenttuberculous lymphadenitis. Following exploration of CBD,histopathological report of CBD and lymph node he made acomplete recovery.