Potts Whipple

The Other Whipple: 

The Other Whipple John R. Potts, III, M.D. Professor of Surgery Program Director in Surgery Assistant Dean Graduate Medical Education University of Texas Medical School Houston

Allen O. Whipple: The Surgeon: 

Allen O. Whipple: The Surgeon Pancreaticoduodenectomy Pancreatic Endocrine Tumors Portocaval Shunt 1881 - 1963

A.O. Whipple – Early Years: 

A.O. Whipple – Early Years Born Urmia, Persia Lived 14 years in Persia Worked way through school Princeton 1904 MD Columbia P&S 1908 Internship Roosevelt & Sloan Hospitals 1909 - 1910

A.O. Whipple at Columbia-Presbyterian: 

A.O. Whipple at Columbia-Presbyterian 1911 faculty Columbia P&S Staff, Presbyterian Hospital 1921 Professor of Surgery 1921 Surgeon in Chief, PH 1931 Valentine Mott Chair 1946 Retired

Pancreaticoduodenectomy: 

Pancreaticoduodenectomy Ann Surg 1935; 102:763-769 First Operation Second Operation End Result

Whipple’s Thoughts on Whipples: 

Whipple’s Thoughts on Whipples Urged the following factors be considered: The threat of disease The operative risk The probability of cure The assurance of relief of symptoms Patient ability to adapt to GI dysfunction Quality of the resident staff Experience, skill & integrity of the surgeon Ann Surg 1935; 102:763-769

Whipple’s Thoughts on Whipples: 

Whipple’s Thoughts on Whipples Discussing prior attempts at pancreatic resection for cancer, “…the mistaken belief that the flow of pancreatic juice is essential to life, which led surgeons to attempt to reestablish this flow into the duodenum or jejunum by implanting the resected head of the pancreas or the cut end of the duct into the upper intestine. The activation of the pancreatic ferments by duodenal contents compromised any type of anastomosis in the human subject, especially around the posterior aspect of the duodenum devoid of peritoneum.”

Whipple’s Results With Whipples: 

Whipple’s Results With Whipples First report (1935): 3 patients 2 died post-op F/U on 3rd about four months First one-stage resection 3/8/1940 Whipple’s total experience: 37 cases 30 periampullary tumors 7 chronic pancreatitis

Whipple’s Triad: 

Whipple’s Triad Symptomatic hypoglycemia while fasting Documented glucose <50 mg/dL Symptomatic relief with glucose administration Ann Surg 1935; 101:1299-1335.

Portal Hypertension: 

Portal Hypertension Whipple AO Ann Surg 1945; 122:449-475

A.O. Whipple on Shunt Surgery: 

A.O. Whipple on Shunt Surgery Rationale: Bleeding was NOT controlled by splenectomy Spontaneous loss of portal flow in cirrhosis Encephalopathy controlled by dietary measures New methods promised good shunt patency Whipple AO Ann Surg 122:449;1945

Slide12: 

Whipple AO Ann Surg 122:449;1945

Portocaval Shunt Results: 

Portocaval Shunt Results 1945 report 10 patients 5 portocaval 5 spenorenal [central] All survived operation Profound influence Whipple AO Ann Surg 122:449;1945

Other Surgical Contributions: 

Other Surgical Contributions Combined Spleen Clinic Weekly M&M First chair to hire black surgeon

A.O. Whipple - Honors: 

A.O. Whipple - Honors Honorary degrees: Columbia U Chicago Washington U Princeton Distinguished service awards: Columbia-Presbyterian Medical Center American College of Surgeons American Medical Association

A.O. Whipple - Honors: 

A.O. Whipple - Honors President, American Surgical Assoc Honorary Fellow Royal College of Surgeons Honorary Member, Southern Surgical Assoc National Research Council (WWII) Consultant for Counsel of GB in North Africa Charter member ABS President, NY State Surgical Society (First) Graham Award, Washington U Charter Trustee, Princeton U Woodrow Wilson Award

Slide17: 

A.O. Whipple at MD Anderson Cancer Center 1948

Slide18: 

Samir Johna and Moshe Schein (eds). The Memoirs of Allen Oldfather Whipple: The Man Behind the Whipple Operation Harley, Shrewsbury, Shrops, UK, tfm Publishing Ltd, 2003.

Other Whipples: 

Other Whipples

George Whipple: The Pathologist : 

George Whipple: The Pathologist 1878 - 1976

George H. Whipple - Pathologist: 

George H. Whipple - Pathologist Born 28 Aug 1878 Ashland, NH 3rd generation physician Andover → Yale → Hopkins

Hopkins 1905 - 1914: 

Hopkins 1905 - 1914 1905 Asst Prof Pathology William H. Welch Hepatic repair & regeneration after chloroform anesthesia Mechanisms of jaundice Formation of bile pigments outside the liver

U. California 1914 - 1921: 

U. California 1914 - 1921 Hooper Foundation Professor of Pathology Production of hemoglobin to understand jaundice Acute anemia in dogs Diets & blood formation Dean, 1920 - 1921

U. Rochester 1921 - 1955: 

U. Rochester 1921 - 1955 Founding Dean (Age 43) Professor & Chair Pathology Chronic anemia & diet Tx pernicious anemia

G.H. Whipple’s Nobel Prize1: 

G.H. Whipple’s Nobel Prize1 1 Prize shared with George Richards Minot & William Parry Murphy

G.H. Whipple’s Nobel Prize: 

G.H. Whipple’s Nobel Prize

GH Whipple – Other Studies: 

GH Whipple – Other Studies Tuberculosis Pancreatitis Chloroform poisoning Constituents of bile Metabolism of iron Regeneration plasma protein Stroma of red cells Protein metabolism

Whipple’s Disease (Duodenum): 

Whipple’s Disease (Duodenum) Low Power H & E Low Power PAS EM

G.H. Whipple – Other Honors: 

G.H. Whipple – Other Honors Honorary doctorates – U.S., Athens, Glasgow Popular Science Gold Medal & Annual Award William Wood Gerhard Gold Medal Trustee, Rockefeller Foundation Corresponding member Association of Physicians, Vienna Royal Society of Physicians, Budapest European Society of Haematology British Medical Assoc Honorary Member American Philosophical Society Society of Experimental Biology and Medicine

Eck’s Fistula: 

Eck’s Fistula

Other Whipples: 

Other Whipples

Slide32: 

USS Whipple (DD 15) USS Whipple (DD 217) USS Whipple (DE 1062) Commodore Abraham Whipple 1733 - 1819

Slide33: 

Beverly Whipple, PhD, RN, FAAN

…and now,“The Other Whipple”: 

…and now, “The Other Whipple”

Allen O. Whipple: The Educator : 

Allen O. Whipple: The Educator 1881 - 1963

A.O. Whipple: The Educator: 

A.O. Whipple: The Educator Missionary parents “Poor but well educated” Read and spoke: Arabic, Armenian, Persian, French, Latin, Syriac, Turkish Authority on literature, history, anthropology, archeology & art

Allen O. Whipple: The Educator: 

Allen O. Whipple: The Educator First residency in New York American Board of Surgery The Whipple Society Activities in retirement 1881 - 1963

First Residency in New York: 

First Residency in New York “By far the greatest contribution to American Surgery was Halsted’s initiating the Surgical Residency Training Program when he began his operative work at Hopkins.” A.O. Whipple The Evolution of Surgery in the United States, p.60

First Residency in New York: 

First Residency in New York Residency not looked favorably upon by: Senior attendings, Young attendings Interns Acceptance delayed by observing Halsted Long operations Dominated by [Chief] Resident A.O. Whipple. The Evolution of Surgery in the United States, p.54-55

First Residency in New York: 

First Residency in New York Columbia-Presbyterian residency started 1921 “I did not call the men residents, but to initiate the program with as little prejudice as possible, called them Fellows in Surgery. It was not until several years later, when George Heuer came to New York Hospital and began his residency there…that we called our men Residents” A.O. Whipple. The Evolution of Surgery in the United States, p.55

A.O. Whipple and ABS: 

A.O. Whipple and ABS Appointed by ASA to “National Committee” (Edward W. Archibald, President 1935) Attended every organizational meeting of ABS Appointed by ASA to newly formed ABS First Vice-Chair ABS Chaired 1st Examination Committee Sponsored 1st examination in NYC (9/20/37) 2nd Chair ABS Chaired ABS during World War II J.S. Rodman. History of the American Board of Surgery 1937-1952

Slide42: 

JS Rodman. History of the American Board of Surgery. Philadelphia: JB Lippincott Company, 1956.

Whipple Society: 

Whipple Society Established 1952 by 300 former residents Soon accepted other members The Training of Surgeons in the Future (1967) ? other published proceedings

Whipple Society: 

Whipple Society “The purpose of the Society shall be to foster and preserve the ideals and teachings of Allen O. Whipple, to promulgate the practice of these principles in the teaching of surgery, and to make a continuing study of surgical education.”

Whipple Society: 

Whipple Society The first organization for surgical education The only such organization 1957 – 1978 Only after Whipple society disbanded: Association for Surgical Education Association of Program Directors in Surgery

A.O. Whipple – The Educator: 

A.O. Whipple – The Educator After “Retirement” in 1946: 1941-1957 Trustee American Univ. Beirut 1946-1951 Reorganized training Memorial Hospital 1946-1954 Plans for Nemazee Hospital then Pahlavi University Medical School 1951-1963 Trustee at Princeton Pre-med advisor at Princeton 1957 The Evolution of Surgery in the United States

A.O. Whipple – The Educator: 

A.O. Whipple – The Educator “Among his greatest contributions has been his selfless devotion to the teaching, guidance and encouragement of others.” “He stimulated not only dedication in others but integrity, moral force and responsibility as well…” “He was respected by scholars and loved by his students.” “One of his primary concerns was excellence in surgical education”

Summary: 

Summary Allen O. Whipple – The Surgeon George H. Whipple – The Pathologist Allen O. Whipple – The Educator