The Whipple operation was adapted and advanced outside of its eponym’s expe­rience. For instance, Whipple was initially averse to reconstructing the pancreatic duct, believing the anastomosis would place the other anastomoses at risk due to the activation of pancreatic enzymes in the duodenum. However, this approach led to frequent pancreatic stulas, and in 1941, Verne Hunt successfully incorporated a pancreaticojejunostomy procedure to avoid pancreatic stump leakage [5]. This sur­gery of the pancreas also show high rates of marginal ulceration until the gastric anastomosis was moved from the most proximal to the most distal of the anastomo­ses, and adequate gastrectomy was routinely practiced [6]. In 1978, Traverso and Longmire reintroduced the idea of pylorus preservation, rst described by Kenneth Watson in 1944, further reducing the frequency of marginal ulcers [7, 8]. The 1980s and beyond saw the dramatic reduction in mortality rates following the Whipple procedure from 20% to 40% to <5%, attributed to the centralization of this complex operation to high-volume centers and pioneered under the leadership of John Cameron at Johns Hopkins Hospital [9–11].