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Let´s talk a bit about history of pancreatology (I love it!) #PancreasHistory
Today´s menu: pancreatoduodenectomies
Who was Whipple? Was Whipple the first human on Earth to remove a pancreas? #UEGambassador @my_ueg @hpb_so @me4_so #SoMe4Surgery @juliomayol @chiaro_del
Today´s menu: pancreatoduodenectomies
Who was Whipple? Was Whipple the first human on Earth to remove a pancreas? #UEGambassador @my_ueg @hpb_so @me4_so #SoMe4Surgery @juliomayol @chiaro_del
The first successful pancreatoduodenectomy was in fact performed in 1909 by Walther Kausch, a German surgeon, in a patient with ampullary cancer. As the patient was jaundiced and had coagulopathy (vitamin K was not synthetized yet) he had to do a 2-stage procedure
First he made a cholecystojejunostomy, to allow the patient to decrease the jaundice and improve the coagulopathy
...then 9 days later he removed the duodenum (2nd and 3rd parts), the distal bile duct and part of the head of the pancreas (see https://www.sciencedirect.com/science/article/pii/S0002961007004369 for more details). The patient survived 9 months and died of acute cholangitis without evidence of relapse at autopsy, wow
Allen Whipple was born in Urmia, West Azerbaijan, Iran. His parents were Presbyterian missionaries. He was deeply religious and loved history, and even wrote some historical works about the Nestorians as a link between Greek and Arabic medicine https://www.gastrojournal.org/article/S0016-5085(07)00589-6/abstract
According to this note in Gastroenterology @AGA_Gastro, it is said that during operations he would instruct his assistants to vary tempo by using musical terms: andante, to slow down, and allegro, to speed up https://www.gastrojournal.org/article/S0016-5085(07)00589-6/abstract
In 1935 he performed his first PD, he used a 2-stage procedure, similar to Kausch´s procedure. The first patient unfortunately died, but Whipple started to improve the procedure and the next 2 patients with the 2-stage procedure survived.
In 1939 Vitamin K was available so Whipple decided to perform PD in 1 procedure, he did it successfully on 1940. By 1945 he had performed 27 PDs; the survival rate was 2 every three patients, not bad in those times!
If you have enjoyed it, read this article about pioneers of pancreatic surgery by 2 giants: Fernandez del Castillo & Warshaw @MassGeneral: https://www.sciencedirect.com/science/article/pii/S0002961007004369
Finally, a book in Spanish about the history of pancreatology from one of my Masters, Salvador Navarro, from @hospitalclinic is going to be published soon @AESPANC @frankbalaguer
Addendum thanks to @chiaro_del! Alessandro Codivilla, an Italian surgeon, performed a 1-stage PD in 1898 when he was 27! The details of the procedure are not clear (it was not published) and the patient died 24 days later, but this was the first PD ever
Unfortunately there is no record of later PDs by Alessandro
@schgastro @sage_gastro @Gastrocivil @gastromx @aegastro @AcademiaCirugia @HPBcolombia @HpbKarolinska @hpbjournal @SurgeryHPB @AnnalsofSurgery @JAMASurgery @SOCICH_ @CirujanosMad
