PATHOLOGY OF PANCREATICODUODENECTOMY SPECIMENS IN INDUSTRIAL ORGANIZATION OVER THREE YEARS

Dr. Seema Chadha, Dr. Niharika Singh, Dr. Rakesh Kumar, Dr. Sanjeev Singhal, Dr. Shilpa Ruhela, Dr. Awantika Tiwari

ABSTRACT

Background: Whipple procedure is performed for various tumors of the periampullary region. Mortality and morbidity of patients undergoing Whipple procedure has been reduced significantly. The prognosis of such patients invariably depends on precise histopathological examination of Whipple specimen including tumor type, tumor site, tumor size, tumor extent, margin status, angioinvasion, perineural invasion and lymph node status. Material and Methods: A retrospective descriptive study was conducted in the Department of Pathology, Northern Railway Central Hospital. Various histopathological parameters like, location of the tumor, tumor morphology, grading, lymphovascular/perineural invasion, margin status and lymph node status were assessed. Also TNM staging of the tumor was done. Result: Sixteen patients underwent Whipple’s Pancreaticoduodenectomy procedure during the study period. Among the 16 specimens, malignant tumor was present in 12 cases (75%), whereas 4 cases (25%) were benign. Periampullary mixed carcinoma was the predominant tumor (25%) followed by pancreatic adenocarcinoma (18.75%), neuroendocrine tumor (18.75%), periampullary duodenal (12.5%), ampullary carcinoma (12.5%), and papillary adenocarcinoma of common bile duct (6.25%). Benign gastrointestinal stromal tumor were (6.25%). Conclusion: Pancreaticoduodenectomy specimen requires detailed histopathological evaluation for proper histological type, stage and other features which affect patient survival following Whipple’s procedure. The present study showed that most of our subjects were diagnosed with malignancy, at an advanced stage, and further research is needed to develop practical methods for early diagnosis.

Keywords: Whipple, Pancreaticoduodenectomy, ampullary.