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| 1 | Whipple’s pancreaticoduodenectomy at a resource-poor,low-volume center in Trinidad and Tobago显示文摘BACKGROUND Many authorities advocate for Whipple’s procedures to be performed in highvolume centers,but many patients in poor developing nations cannot access these centers.We sought to determine whether clinical outcomes were acceptable when Whipple’s procedures were performed in a low-volume,resource-poor setting in the West Indies.AIM To study outcomes of Whipple’s procedures in a pancreatic unit in the West Indies over an eight-year period from June 1,2013 to June 30,2021.METHODS This was a retrospective study of all patients undergoing Whipple’s procedures in a pancreatic unit in the West Indies over an eight-year period from June 1,2013 to June 30,2021.RESULTS This center performed an average of 11.25 procedures per annum.There were 72 patients in the final study population at a mean age of 60.2 years,with 52.7%having American Society of Anesthesiologists scores≥III and 54.1%with Eastern Cooperative Oncology Group scores≥2.Open Whipple’s procedures were performed in 70 patients and laparoscopic assisted procedures in 2.Portal vein resection/reconstruction was performed in 19(26.4%)patients.In patients undergoing open procedures there was 367±54.1 min mean operating time,1394±656.8 mL mean blood loss,5.24±7.22 d mean intensive care unit stay and 15.1±9.53 d hospitalization.Six(8.3%)patients experienced minor morbidity,10(14%)major morbidity and there were 4(5.5%)deaths.CONCLUSION This paper adds to the growing body of evidence that volume alone should not be used as a marker of quality for patients requiring Whipple’s procedures.Low volume centers in resource poor nations can achieve good short-term outcomes.This is largely due to the process of continuous,adaptive learning by the entire hospital. | Shamir O Cawich Dexter A Thomas Neil W Pearce Vijay Naraynsingh | 2022 | World Journal of Clinical Oncology2022，13，9： | 2 |
| 2 | Mitochondrial complex Ⅰ deficiency in Parkinson's disease显示文摘 | Schapira A H bCooper J M Dexter D | 1990 | J Neurochem1990，54，： | 1 |
| 3 | Advances in characterization of soil structure显示文摘 | Dexter A R | 1988 | Soil b- Tillage Research1988，11，： | 1 |
| 4 | Hot water extractable carbon in soils: A sensitive measurement for determining impacts of fertilization on grazing and cultivation 显示文摘 | Ghani A Dexter M Perrot K W | 2003 | Soil Biology and Biochemistry2003，35，： | 1 |
| 5 | Advances in characterization of soil struc- ture显示文摘 | Dexter A R | 1988 | Soil and Tillage Research1988，11，3： | 1 |
| 6 | Hot-water extractable carbon in soils~ A sensitive measurement {or determining impacts o{ {ertilization, grazing and cultivation显示文摘 | Ghani A Dexter M Perrott K W | 2003 | Soil Biology and Biochemistry2003，35，9： | 1 |
| 7 | Electronic Data Interchange and Small Organizations : Adoption and Impact of Technology 显示文摘 | lacovou C L Benbasat I Dexter A S | 1995 | MIS Quarterly1995，19，4： | 1 |
| 8 | Dynamics of soil aggregation in an irrigated desert loe,,:s显示文摘 | HORN R DEXTER A R | 1989 | Soil and Tillage Researeh1989，13，3： | 1 |
| 9 | Research report: Empirical test of an EDI adoption model显示文摘 | Chwelos P Benbasat I Dexter A S | 2001 | Information Systems Research2001，12，3： | 1 |
| 10 | Some mechanical properties of aggregates and the effects of wetting and drying cycles显示文摘 | Dexter A R Kroesbergen B Kuipers H | 1984 | Netherlands Journal Agric Sci1984，32，2： | 1 |
| 11 | Trehalose: a review of properties, history of use and human tolerance, and results of multiple safety studies显示文摘 | RICHARDS A KRAKOWKA S DEXTER L | 2002 | Food Chem Toxicol2002，40，7： | 1 |
| 12 | Hot-water extractable carbon in soils:A sensitive measurement for determining impacts of fertilization, grazing and cultivation显示文摘 | Ghani A Dexter M Perrot K W | 2003 | Soil Biology N- Biochemistry2003，35，： | 1 |
| 13 | The role of lipids in determining spaghetti cooking quality显示文摘 | Matsuo R R Dexter J E Boudreau A | 1986 | Cereal Chem1986，63，6： | 1 |
| 14 | The Role of Lipids in Determining Spaghetti Cooking Quality 显示文摘 | Matsuo R R Dexter J E Boudreau A | 1986 | Cereal Chem1986，63，6： | 1 |
| 15 | Water stress induced by PEG decreases the maximum growth pressure of the roots of pea seedlings 显示文摘 | WHALLEY W BENGOUGH A DEXTER A | 1998 | Journal of Experimental Botany1998，49，： | 1 |
| 16 | What are the Most Important Risk Factors for a Patient's Developing Intraoperative Hypothermia? 显示文摘 | Macario A Dexter F | 2002 | Anesthesiology2002，94，： | 1 |
| 17 | An inferential control scheme for optimizing the operation of boilers in multi-zone heating systems显示文摘 | Liao Z Dexter A L | 2003 | Building Services Engineering Research and Technology2003，24，4： | 1 |
| 18 | A robust model-based ap- proach to diagnosing faults in air-handling units 显示文摘 | NGO D DEXTER A L | 1999 | ASHRAE Transactions1999，105，1： | 1 |
| 19 | Trehalose :a review of properties, history of use and human tolerance, and results of multiple safety studies显示文摘 | RICHARDS A B KRAKOWKA S DEXTER L B | 2002 | Food and Chemical Toxicology2002，40，7： | 1 |
| 20 | Alterations in glutathione levels in Parkinson's disease and other neurodegenerative disorders affecting basal ganglia显示文摘 | SIAN J DEXTER D T LEES A J | 1994 | Ann Neurol1994，36，3： | 1 |
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