<prompt> What is the most common surgical complication following whipple procedure?Disruption of pancreatic anastomosisBiliary peritonitisDisruption of gastric anastomosisGI bleeding  <response>: If disease mainly involves head of the pancreas, then pancreatico-duodenectomy can be done--Whipples procedure.Whipples operation is done by removing tumour with head and neck of pancreas, C loop of duodenum, 40 distal stomach, 10 cm proximal jejunum, lower end of the common bile duct, gallbladder, peripancreatic, pericholedochal, paraduodenal and perihepatic nodes. Continuity is maintained by choledochojejunostomy, pancreaticojejunostomy and gastrojejunostomy. Few advocate pancreaticogastrostomy into posterior wall of the stomach. Moality in Whipples operation is 2-8. Original Whipples operation 1935 was two staged procedure- initial by pass and a second stage resection with closure of pancreatic stump. In 1941, Trimble performed one stage pancreaticojejunostomy. Complications are delayed gastric emptying 19; pancreatic fistula 14; infection intraabdominal abscess, wound infection, cholangitis, pancreatitis, pneumonia; bile leak. Moality is 3. ref:SRB;S manual of surgery,ed 3,pg no 635 