Pancreatic Anastomosis — Flashcards

Flashcard 1: The reconstruction following Whipples procedure or PPPD involves anastomoses of the _____ first, then the bile duct, and, finally, the duodenum or stomach.

Answer: pancreas

Flashcard 2: _____ procedure refers to local resection of the pancreatic head with longitudinal pancreaticojejunostomy (LR-LPJ)

Answer: Frey's

Flashcard 3: What is the second most common surgical complication of Whipples procedure?_____

Answer: Disruption of pancreatic anastomosis

Flashcard 4: Varadhachary-Katz criteria are used to determine the resectability of _____ cancer

Answer: pancreatic

Flashcard 5: What is the treatment of choice for **Main duct** IPMNs of the pancreas?

Answer: Surgical resection (Pancreatectomy)

Extra: Main duct IPMNs (MD-IPMN) have a high risk of malignancy (60-90%) and should be resected in all fit patients. Branch duct IPMNs (BD-IPMN) are managed conservatively with surveillance unless 'high-risk stigmata' (e.g., obstructive jaundice, enhancing mural nodule ≥5 mm, main pancreatic duct ≥10 mm) are present.

Flashcard 6: Treatment for annular pancreas is _____

Answer: bypass (duodenoduodenostomy).

Flashcard 7: Most common cause of death following pancreaticoduodenectomy is _____ due to anastomotic leakage.

Answer: sepsis

Flashcard 8: What 7 structures are removed during a classic Whipple’s procedure (Pancreaticoduodenectomy)?

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

Flashcard 9: Surgery of choice for treatment of carcinoma of the body and tail of the pancreas is _____ along with splenectomy

Answer: distal pancreatectomy

Flashcard 10: Passaro's triangle (Gastrinoma triangle) is bounded by: - _____ duct junction - Junction of the 2nd and 3rd parts of the duodenum - Junction of the neck and body of the pancreas

Answer: Cystic