Pancreatic Surgery — Flashcards

Flashcard 21: What is the most common site of pseudoaneurysm in chronic pancreatitis?_____

Answer: Splenic artery

Flashcard 22: What is the second most common surgical complication of Whipples procedure?_____

Answer: Disruption of pancreatic anastomosis

Flashcard 23: How do we differentiate between an infected and a sterile pancreatic necrosis?

Answer: CT-guided Fine Needle Aspiration (FNA)

Extra: While Contrast-Enhanced CT (CECT) is the gold standard for diagnosing pancreatic necrosis, it cannot reliably differentiate sterile from infected necrosis unless air/gas bubbles are seen (a specific but insensitive sign). CT-guided FNA for Gram stain and culture is the classic diagnostic tool used to confirm infection.

Flashcard 24: 90% of the gastrinomas are found in the _____ triangle

Answer: Passaro's

Flashcard 25: _____ is the most common complication following Whipples procedure.

Answer: Delayed gastric emptying

Flashcard 26: Distal resection of the pancreatic tail, with end-to-end pancreaticojejunostomy, is known as _____ procedure.

Answer: Duval

Flashcard 27: Is it possible to manage infected pancreatic necrosis with antibiotics alone?

Answer: Yes (approximately 1/3 of patients respond to antibiotics alone)

Flashcard 28: Pancreatic tumor involvement of the splenic artery or vein _____ preclude surgery.

Answer: does not (does/does not)

Flashcard 29: What 7 structures are removed during a classic Whipple procedure (pancreaticoduodenectomy)?

Answer: 1. Head and uncinate process of pancreas 2. Duodenum 3. Distal stomach (Antrum) 4. Gallbladder 5. Distal common bile duct 6. Proximal jejunum 7. Regional lymph nodes

Extra: Note: Pylorus-preserving pancreaticoduodenectomy (PPPD) is a modification where the stomach and pylorus are preserved.

Flashcard 30: _____ is major complication following cystogastrostomy.

Answer: Hemorrhage