In Reply.–Dr Braasch would have us believe that only surgeons with great experience are capable of safely performing the Whipple operation. However, the success or failure of this or any other operation will depend on multiple factors, which, in addition to personal experience, include the operator's technical skill, knowledge of the literature, and careful attention to the fundamental principles of patient care. Although personal experience is an important factor, the lack of it, as our series demonstrates, may at least in part be overcome by a careful study of the experience of others. At the same time, as many of the larger series of Whipple operations have shown, experience alone is no guarantor of success.
Dr Braasch criticizes the small size of our series. This is the "Catch 22" of the situation. If the numbers were greater, then the favorable results would have been attributed to considerable experience! Our