Almenara Hospital reaches surgery’s “Mount Everest” with more than 95% survival rate

Pancreatic surgery is often described as medicine’s “Mount Everest,” and doctors at Peru’s Guillermo Almenara Irigoyen National Hospital say their results show that the demanding procedure can be performed with a survival rate above 95%.

The finding comes from a review of 414 patients who underwent a pancreatoduodenectomy, commonly known as the Whipple procedure, between 2009 and 2023. The operation is used mainly to treat tumors in the head of the pancreas and nearby areas. The results were published in HPB Journal, a specialist publication in hepatopancreatobiliary surgery.

During the 15-year period, operative mortality remained below 5%, a measure used internationally to assess the safety of the procedure. The hospital created a system to record each operation, identify complications and review outcomes. Surgeons, anesthesiologists, intensive-care specialists, nurses and nutritionists coordinated patient care.

“If we do not investigate and measure, we do not know whether we are truly succeeding,” said Gustavo Reaño-Paredes, the study’s lead author. He worked with Fritz Kometter Barrios, head of the hospital’s Pancreatic Surgery Service.

The study also identified a worsening condition among patients arriving for surgery. In the most recent five years examined, more patients had substantial weight loss, physical deterioration and advanced chronic illnesses. Preoperative cholangitis, an infection of the bile ducts caused by tumor-related obstruction, was also identified as a complicating factor.

Doctors highlighted jaundice, persistent abdominal pain and unexplained weight loss as warning signs requiring medical evaluation. Ampullary adenocarcinoma accounted for 43.2% of cases. The tumor develops where the bile and pancreatic ducts meet and can cause early jaundice, sometimes allowing earlier detection. One patient, Jenny Espinosa, traveled to Lima from Cusco after receiving an initial prognosis of 30 days. Following three complex operations at Almenara, she has lived for 14 years.

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If we do not investigate and measure, we do not know whether we are truly succeeding.