Opinion Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2022; 10(22): 7620-7630
Published online Aug 6, 2022. doi: 10.12998/wjcc.v10.i22.7620
Whipple’s operation with a modified centralization concept: A model in low-volume Caribbean centers
Shamir O Cawich, Neil W Pearce, Vijay Naraynsingh, Parul Shukla, Rahul R Deshpande
Shamir O Cawich, Vijay Naraynsingh, Department of Clinical Surgical Sciences, University of the West Indies, St Augustine 000000, Trinidad and Tobago
Neil W Pearce, University Surgical Unit, Southampton General Hospital, Southampton SO16 6YD, United Kingdom
Parul Shukla, Department of Surgery, Weill Cornell Medical College, New York, NY 10065, United States
Rahul R Deshpande, Department of Surgery, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom
Author contributions: Cawich SO, Naraynsingh V, Deshpande R and Shukla P designed and coordinated the study; Pearce NW, Deshpande R, Shukla and Naraynsingh V acquired and analyzed data; Cawich SO, Naraynsingh V, Deshpande R and Shukla P and Pearce NW interpreted the data; Cawich SO, Naraynsingh V, Deshpande R and Shukla P and Pearce NW wrote the manuscript; all authors approved the final version of the article.
Conflict-of-interest statement: All authors report no relevant conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shamir O Cawich, FRCS, Full Professor, Department of Clinical Surgical Sciences, University of the West Indies, St Augustine Campus, St Augustine 000000, Trinidad and Tobago. socawich@hotmail.com
Received: December 11, 2021
Peer-review started: December 11, 2021
First decision: April 16, 2022
Revised: May 5, 2022
Accepted: June 26, 2022
Article in press: June 26, 2022
Published online: August 6, 2022
Processing time: 222 Days and 15.9 Hours
Core Tip

Core Tip: The published data generally support pancreaticoduodenectomies (PD) being reserved for high volume hospitals. However, this is not practical in resource-poor, low volume countries in the Caribbean. Nevertheless, we have documented good short-term outcomes after PD in this setting. In this paper we discuss a modified centralization concept used to incorporate PD into these low volume centers.