During Whipple's procedure (pancreaticoduodenectomy), the reconstruction involves a hepaticojejunostomy, pancreaticojejunostomy, and gastrojejunostomy in a specific sequence. The most common and most serious early complication of the Whipple procedure is:

• A Delayed gastric emptying (DGE)
• B Post-pancreatectomy haemorrhage
• C Postoperative pancreatic fistula (POPF) ✓
• D Bile leak

Explanation

Postoperative pancreatic fistula (POPF/CR-POPF) is the most feared complication after Whipple's procedure, occurring in 10–25% of cases and driving secondary complications like haemorrhage, sepsis, and mortality. It arises from an insecure pancreaticojejunostomy, particularly in soft pancreatic texture with a small duct. Delayed gastric emptying is more common (20–50%) but rarely life-threatening. Post-pancreatectomy haemorrhage (PPH) may be a consequence of sentinel bleed from POPF-induced pseudoaneurysm.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.